Journal of Lumbini Medical College (Sep 2018)

Efficacy of intravenous paracetamol and intravenous diclofenac as postoperative analgesia in laparoscopic cholecystectomy: A Randomized controlled trial

  • kalpana kharbuja,
  • Anup Acharya

Journal volume & issue
Vol. 6, no. 1

Abstract

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Background: Though the development of minimally invasive laparoscopic surgery mainly laparascopic cholecystectomy has revolutionized field of surgery but postoperative pain is very common after surgery. Previously opiod has been commonly used for pain management. Since opiod has many adverse side effects so in this study we planned to compare intravenous paracetamol and intravenous diclofenac as postoperative analgesia and find the best alternative of opiod. Methods: 128 patients with ASA I and II were included in this randomized clinical trial study divided into two groups in a stipulated time of 1 year in Lumbini medical college. Anaesthesia induction and maintenance were standardized. The first group received 15mg/kg (maximum 1gm) injection paracetamol and second group received 2mg/kg (maximum 75mg) injection diclofenac 30 minutes prior ending of surgery. A questionnaire was responded by patients and chart was maintained by visual analogue scale. For analyzing data ,computer software excel & SPSS version 20 was used. P value <0.05 is considered statically significant. Results: Profiles of hemodynamic changes were almost similar in both groups in respect of heart rate and blood pressure. However, paracetamol infusion provided hemodynamic stability in post-operative period. We have observed significant outcomes (P-values are 0.001 at 0 hrs, 0.001 at 2 hrs, 0.04 at 12 hrs and 0.018 at 24 hrs) in VAS pain score in between the two groups. Most of the patients in paracetamol group had low VAS score in post-operative period and provided an extended analgesia compared to diclofenac. No serious postoperative complication was observed in patients given paracetamol. Conclusion: Administration of intravenous paracetamol has better and prolonged analgesic effect with low pain scores and lesser requirement for rescue analgesia compared to diclofenac.

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