Efficacy of Preemptive and Preventive Analgesia in Reducing Postoperative Rescue Analgesic Requirements in Surgical Patients

Background: To compare the efficacy of pre-emptive and preventive analgesia on postoperative requirement of rescue analgesic in surgical patients within 24 hours; along with haemodynamic changes. Design: Prospective randomized study. Materials and method: This study involved total of 90 patients, of either gender, aged between 18-65 years, belonging to American Society of Anesthesiology [ASA] grade I and II, who underwent surgery under general anaesthesia lasting up to 2 hours .They were randomly assigned into three groups: GROUP I-Preemptive group received1gm of IV Paracetamol(100ml) prior to skin incision and IV normal saline [NS](100 ml) prior to end of surgery; GROUP II- preventive group received IV NS(100 ml) and 1gm of IV Paracetamol(100ml) before skin incision and closure respectively ; GROUP-ⅠⅠⅠ control group received 100 ml of intravenous (IV) NS before skin incision and before closure. Results: Pain scores between both Preemptive and Preventive groups observed to be non significant up to 24 hours. Between Group I vs Group III mean pain scores was observed to be higher in Control group and found to be statistically significant (P˂0.05)up to 12 hours, whereas at 24 hours it was statistically non-significant. In comparison between the Group II vs Group III mean pain scores were statistically significant until 8 hours, whereas at 12 hours and 24 hours were found to be non-significant. Conclusion: Surgical patients undergoing surgery under general anaesthesia preemptive analgesia may provide adequate analgesia and stable hemodynamics perioperatively and decrease postoperative analgesic consumption whereas preventive analgesia provides relief in postoperative period.