Key result
Preoperative intravenous administration of paracetamol significantly reduced post-cesarean pain scores at 6 hours (4.01 vs 4.83, p=0.008) and 24 hours (2.26 vs 2.67, p=0.038) compared to placebo.
Why the study?
Post-cesarean pain control with minimal opioid use is important, and paracetamol is a non-opioid analgesic with few complications.
Does preoperative intravenous paracetamol reduce post-cesarean pain in pregnant women undergoing elective cesarean section?
RCT (n=240)
Double-blind
Simple randomized pairing method
No
Does preoperative intravenous paracetamol reduce post-cesarean pain in pregnant women undergoing elective cesarean section?
Absolute Event Rate: 4.01% vs 4.83%
p-value: p=0.008
Preoperative intravenous administration of paracetamol significantly reduces post-cesarean pain at 6 and 24 hours compared to placebo.
Preoperative IV paracetamol reduces post-cesarean pain; extends opioid-sparing evidence and supports integration into multimodal protocols.
Background Pain control after every surgery, especially cesarean is highly important, and physicians are striving to discover pain control methods using the least amount of opioid and Paracetamol is a non-opioid analgesic with few complications. The present study was aimed to investigate the analgesic effect of preoperative intravenous administration of paracetamol on post-cesarean pain.Methods This randomized double-blind clinical trial was conducted on 240 pregnant women under spinal anesthesia who were candidate for elective cesarean. The patients’ weight, height, age and body mass index (BMI) were recorded, and patients were randomly divided into two equal groups (n=120). In the first group, 10 mg/kg paracetamol in 100cc normal saline (paracetamol group) and in the second group 100cc normal saline (control group) administered 15 minutes before surgery intravenously. Blood pressure, pulse rate, chills and nausea were recorded during and 1 hour after surgery, and pain visual analogue scale (VAS) and need for additional analgesic were recorded 1, 2, 4, 6, 12 and 24 hours after surgery.Results No significant difference was found between the two groups in frequency of chills and nausea (p>0.05). Mean pethidine consumed was lower in paracetamol group than control group but not significantly. Systolic blood pressure of both groups during surgery and one hour after surgery did not show a significant difference, but diastolic blood pressure was significantly lower in paracetamol group 15 minutes (p=0.046) and 60 minutes after surgery (p=0.042) than control group. The mean scores of pain were significantly lower in paracetamol group than control group 6 hours (0.008) and 24 hours (p=0.038) after surgery.Conclusions Within the limitations of the current study, preoperative intravenous administration of paracetamol significantly reduced post-cesarean pain within 24 hours.
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Moghadam et al. (2019) conducted an RCT in Post-cesarean pain (n=240). Paracetamol vs. 100 cc normal saline was evaluated on Pain score (VAS) at 6 hours post-surgery (p=0.008). Preoperative intravenous administration of paracetamol significantly reduced post-cesarean pain scores at 6 hours (4.01 vs 4.83, p=0.008) and 24 hours (2.26 vs 2.67, p=0.038) compared to placebo.
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