DOI: http://dx.doi.org/10.18203/2349-2902.isj20191896

A comparative evaluation of analgesic effects of using intravenous paracetamol versus intravenous diclofenac post-operatively in laparoscopic cholecystectomy patients in SMIH, department of surgery, Dehradun

Anurag Bijalwan, Pradeep Singhal, Syed Altamash

Abstract


Background: Post-operative adequate analgesia plays an important role in early mobilization, short hospital stay and patient satisfaction in laparoscopic cholecystectomy. The use of opioids for providing postoperative analgesia has been marked by side effects like vomiting, nausea, sedation, respiratory distress, etc. hence, alternate drugs like paracetamol (PCM) and diclofenac are commonly used. In this study, we have compared the analgesic efficacy and any associated side effects of the two commonly used non-opioid NSAIDS namely paracetamol and diclofenac.

Methods: We compared 50 patients undergoing laparoscopic cholecystectomy in ASA I and II. They were randomly divided into two groups, Group A and Group B. Group A was administered intravenous PCM and Group B was administered injection diclofenac sodium. Postoperatively, these patients were assessed for pain, blood pressure, respiratory rate, and presence of any side effects like nausea, vomiting or any respiratory discomfort.

Results: The mean DBP, MAP and VAS score was significantly (p-value <0.05) in Group A as compared to Group B patients at 4, 8, 12 and 24 hours postoperatively. There was no statistically significant difference in mean SBP and O2 saturation in both groups. The mean pulse rate was lower in Group A as compared to Group B at 8, 12 and 24 hours.

Conclusions: This study concluded that postoperative PCM infusion provided better analgesia for a prolonged period of time with minimal side effects.

 


Keywords


Lap cholecystectomy, Analgesia, Paracetamol, Diclofenac

Full Text:

PDF

References


Litynski GS. Highlights in the History of Laparoscopy. Frankfurt, Germany: Barbara Bernert Verlag; 1996: 165–168.

Dunn MD, Shalhav AL, McDougall EM, Clayman RV. Laproscoic nephrectomy and nephroureterectomy for renal and upper tract transitional cell cancer. Semin Laparosc Surg.2000;7:200-10.

Gill IS, Matin SF, Desia MM, Kaouk JH, Steinberg A, Mascha E. Comparative analysis of laparoscopic versus partial nephrectomy for renal tumors in 200 patients. J Urol. 2003;170:64-8.

Upadya M, Pushpavathi SH, Seetharam KR. Comparison of intra- peritoneal bupivacaine and intravenous paracet postoperative pain relief after laparoscopic cholecystectomy. Anaesthesia Essays and Researches. 2015;9(1):39-43.

Clayman RV, Kavoussi LR, Soper NJ, Meretyk S, Darcy MD. Laparoscopic nephrectomy: initial case report. J Urol. 1991;146:278-82.

Imani F, Rahimzadeh P, Faiz SHR. Comparison of the efficacy of adding clonidine, chlorpromazine, promethazine and midazolam to morphine pumps in postoperative pain control of addicted patients. Anesth Pain, 2011;1(1):10-4.

Shoar S, Esmaeili S, Safari S. Pain management after Surgery: A Brief Review. Anesth Pain. 2012;1(3):184-6.

Imani F, Rahimzadeh P. Gabapentinoids: Gabapentin and Pregabalin for post-operative pain management. Anesth pain. 2012; 2(2):52-3.

Hurley RW. Acute post-operative pain. In: Millers Anaesthesia, Miller RD, Fleisher LJ, Wiener-Kronish JP, Young WI, eds. 7th ed, USA: Ghurchil Livingstone; 2010: 2763.

Yoganarasimhan N, Ragavendra TR, Radha MK, Amitha S, Sridhar K. Comparison of paracetamol infusion with diclofenac infusion for perioperative analgesia. J Med Health Sci. 2012; 1(1):18-22.

Sinatra RS, Jahr JS, Reynolds LW, Viscusi ER, Groudine SB, Payen-Champenois C. Efficiency and safety of single and repeated administration of 1 gm intravenous acetaminophen injection (paracetamol) for pain management after major orthopaedic surgery. Anesthesiology. 2005;102(4):822-31.

Goel P, Kothari S, Gupta N, Kumar A, Chaturvedi SK. Pre emptive analgesia with IV paracetamol and IV diclofenac sodium in patients undergoing various surgical procedures: a comparative study. Int J Biol Med Res. 2013;4(3):3294-300.

Patel MK, Ekka M, Ekka S. Dalai H, Pujahari PSP. A Comparative Study of Preemptive Analgesic Property of Intravenous Paracetamol and Diclofenac Sodium. J Evid Based Med Healthc. 2018;5(6):477-82.

Amin A, Najeeb R, Parveen S, Ommid M, Shahnaz B. Comparison of analgesic effect of intravenous paracetamol and intravenous diclofenac for perioperative analgesia in laparoscopic cholecystectomy. IOSR J Dental Med Sci. 2016;15(2):26-31.

Gohil P, Gauri MP, Raval B. Comparative evaluation of efficacy of intravenous paracetamol and intravenous diclofenac as post-operative analgesic in laparoscopic surgery. Int J Med Res. 2018;3(1):45-9.

Paul D, Jacob M, Kulkarni S. Comparative evaluation of efficacy of intravenous paracetamol and intravenous diclofenac as post-operative analgesia in laparoscopic cholecystectomy. IJBR. 2015;6(7):482-7.