Key result
Preoperative intravenous paracetamol reduced the total amount of postoperative pethidine required compared to normal saline.
Why the study?
Paracetamol can provide afferent blockade of nociceptive impulses throughout the intraoperative and postoperative period, but its preoperative intravenous effect in laparoscopic cholecystectomy needed evaluation.
Does preoperative intravenous paracetamol reduce postoperative pain and opioid consumption in adult patients undergoing laparoscopic cholecystectomy?
RCT (n=60)
Single-blind
Computerized random table
No
Does preoperative intravenous paracetamol reduce postoperative pain and opioid consumption in adult patients undergoing laparoscopic cholecystectomy?
Preoperative intravenous paracetamol significantly reduces postoperative opioid consumption and delays the need for first analgesic in patients undergoing laparoscopic cholecystectomy.
This is the authors' abstract. We don't add key points for this paper.
Background: Afferent blockade of nociceptive (pain) impulses by paracetamol can bein effect throughout intraoperative and postoperative period.Objective: To see the effect of preoperative intravenous paracetamol administration in laparoscopic cholecystectomy patients.Methods: This single blind, randomized, prospective, case-control studywas conducted in Department of Anesthesiology, Square Hospitals, Dhaka, Bangladesh, between July and December of 2014. A total of 60 adult patients scheduled for laparoscopic cholecystectomy under general anesthesiawere enrolled in this study. Patients were randomly allocated equally into two groups – A (cases) and B (controls), through a computerized random table, with 30 patients in each group. Patients of group A (cases) received intravenous paracetamol 10mg/kg (in 100ml of normal saline) 10 minutes before skin incision, while group B (controls) received only 100 ml of normal saline 10 minutes before skin incision. Postoperative pain score, duration of demand of first analgesic after operation and amount of opioid requirement were noted down.Results: The mean age of group A was 39.3±4.3 years and in group B 37.4±4.4 years (P>0.05).The mean pain score after 1 hour of operation was 4.4±0.3 in group A and 4.7±0.3 in group B, which reduced to 2.7±0.3 and 2.9±0.2 after 6 hours, then 1.7±0.2 and 1.8±0.2 after 12 hours and 1.0±0.1 and 1.1±0.2 after 24 hours respectively (P<0.05). Early demand of postoperative analgesic within 10 minutes was observed much less in the group A, compared to group B (P<0.001). The mean amount of pethidine required at 1st hour was 34.8±5.4 mg and 36.6±5.0 mg in group A and group B respectively, which increased up to 77.3±10.7 mg and 92.1±8.5 mg respectively at 6th hour. However, the amount steeply decreased at 12th hour to 29.4±5.4 mg and 28.1±4.7 mg respectively (P<0.001). The total amount of pethidine needed was significantly lower in the group A than that of group B (126.8±14.4 vs. 139.6±9.5 mg; P<0.05).Conclusion: Preoperative load of intravenous paracetamol increases the duration of further analgesic requirement as well as reduces postoperative opioid consumption in laparoscopic cholecystectomy patients.International Journal of Human and Health Sciences Vol. 05 No. 02 April’21 Page: 246-250
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Supports preoperative IV paracetamol to reduce opioid needs after laparoscopic cholecystectomy; extends multimodal analgesia evidence in minimally invasive surgery.
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Reza et al. (2020) conducted an RCT in Laparoscopic cholecystectomy (n=60). Intravenous paracetamol vs. 100 ml of normal saline 10 minutes before skin incision was evaluated on Total amount of pethidine needed (p=<0.05). Preoperative intravenous paracetamol reduced the total amount of postoperative pethidine required compared to normal saline.
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