Comparative evaluation of preemptive use of intravenous Paracetamol and intramuscular Diclofenac on postoperative analgesia in lower abdominal surgeries done under spinal anesthesia
Journal Title: MedPulse -International Medical Journal - Year 2017, Vol 4, Issue 4
Abstract
Background: Preemptive analgesia is the treatment that is initiated before occurrence of a painful event (surgical procedure); in order to reduce the physiological consequences of nociceptive transmission provoked by the procedure. Aim and objective: To study and compare the effects of intravenous Paracetamol and intramuscular Diclofenac when used for preemptive analgesia; on postoperative pain, postdural puncture headache (PDPH) and development of chronic pain thereafter. Material and Method: 60 adult patients of either sex of ASA grade Iand II posted for surgery under spinal anesthesia in a stipulated period of 1 year in a tertiary care hospital were enrolled for this study. The patients were divided randomly into 2 groups. The patients from Group A received IV Inj. Paracetamol 1 gm while the patients from Group B received IM Inj. Diclofenac sodium 75 mg;30 minutes prior to spinal anesthesia with injection Bupivacaine 0.5% (Hyperbaric). A questionnaire was responded by all the patients and a chart was maintained for pain score in visual analogue scale and for side effects. Observations and Results: Paracetamol and Diclofenac both the study drugs produced satisfactory postoperative pain relief and there was no incidence of PDPH in either group. Mean duration of analgesia was longer and the difference was statistically highly significant in Group A.( p < 0.005).We found the significant reduction ( p < 0.001 at 1,2,4,6 hr postoperatively) in VAS pain score in intergroup comparison at different time intervals. Group A had shown better outcome with less requirement of rescue analgesia and side effects. The incidence of adverse events was less with group A (20% Vs 43.5%) Conclusion: Compared to intramuscular Diclofenac, intravenous Paracetamol is safer and more effective analgesic when used preemptively for the treatment of postoperative pain after spinal anesthesia.
Authors and Affiliations
Swati Chougule, Jyotsna Paranjpe, Ashwinikumar Patil
Keywords
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