A COMPARISON BETWEEN INTRAVENOUS PARACETAMOL PLUS INTRAVENOUS FENTANYL AND INTRAVENOUS FENTANYL PLUS INTRAVENOUS KETOROLAC FOR POSTOPERATIVE ANALGESIA DURING LAPAROSCOPIC CHOLECYSTECTOMY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 67
Abstract
BACKGROUND Studies have suggested a large inter-individual variation in postoperative pain after laparoscopic cholecystectomy, emphasising the need for improved analgesic treatment and valid predictors. Our study compared the effect of fentanyl plus intravenous paracetamol with fentanyl plus intravenous ketorolac for analgesic efficacy, opioid sparing effects and opioid-related side effects after laparoscopic cholecystectomy. MATERIALS AND METHODS Sixty patients undergoing laparoscopic cholecystectomy were randomised into two groups. Both groups received fentanyl during induction. First group of patients received IV injection of 1 g paracetamol 15 minutes before the end of surgery, while second group received 0.5 mg/kg of IV ketorolac 15 minutes before the end of surgery. The postoperative pain relief was evaluated by a Visual Analog Scale (VAS) using a 100-mm visual analog scale, adverse effects as well as vital signs were recorded every 15 mins for 150 mins or until discharge from the post-anaesthesia care unit. RESULTS The mean VAS score after surgery was less in the group receiving IV ketorolac than receiving IV paracetamol at most of the times, but it was statistically non-significant. The rescue analgesia consumption over first 24 h was also less in the group receiving IV ketorolac (40 ± 25.9 vs. 57 ± 20.1), but it was also statistically non-significant. The time requirement of first dose of rescue analgesic in the postoperative period was prolonged in the group receiving IV ketorolac (240 ± 24.9) than in the group receiving IV paracetamol (170 ± 18.8). There was no difference in the sedation scores and in the incidence of PONV in the two groups. CONCLUSION The study demonstrates the usefulness of both intravenous ketorolac and paracetamol as supplementary analgesic in the treatment of postoperative pain after laparoscopic cholecystectomy
Authors and Affiliations
Sheikh Abdul Mannan, Basharat Ahad, Rabiaarifa Rabiaarifa
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