Study of intravenous paracetamol and intravenous tramadol for post operative analgesia in infra umbilical surgery
Journal Title: Medpulse International Journal of Anesthesiology - Year 2018, Vol 6, Issue 2
Abstract
Background: Relief of postoperative pain is a major concern for patients and anaesthesiologists. Postoperative analgesia has traditionally been provided by opioid analgesics. However, recent trend is to use opioid free analgesia since opioids exhibit a variety of side effects like respiratory depression, nausea, vomiting, urinary retention. Nonsteroidal anti inflammatory drugs (NSAIDs) like ibuprofane, diclofenac also are used but they have damaging effect on kidneys. With the introduction of intravenous Acetaminophen (Paracetamol) a quest for analgesic which is truly devoid of side effects has come to reality. In a dose of 1 gm, its damaging effects on kidney are negligible. In the present study we wish to assess and compare analgesic efficacy and safety of a mild opioid Tramadol with Paracetamol for postoperative analgesia. Aim and Objectives: To evaluate and compare the efficacy and safety of a single dose of intravenous Paracetamol and intravenous Tramadol for post operative analgesia in infra umbilical surgery. Material and Method: This study was done in a tertiary care hospital during the period August 2017 to March 2018. ASA-I or II patients from both the sexes, age group between 18-60 years, scheduled for infra umbilical surgery under spinal anaesthesia were randomly divided in two groups of 36 each. The patients receiving IV infusion of Paracetamol 15 mg/kg (maximum 1g in 100 ml infusion) were included in Group A while patients receiving IV infusion of Tramadol 2 mg/kg (maximum150 mg in 100 ml NS infusion) were included in Group B for the study purpose. The infusions were given over 15 minutes, 20 minutes prior to the end of surgery. arameters recorded were Visual Analogue Scale (VAS), Sedation score, Pulse rate, Mean arterial pressure, Spo2, duration of analgesia and complications like nausea and vomiting, hypotension, bradycardia and respiratory depression. Observation and Results: Data so collected was statistically analysed. Paracetamol and Tramadol both produced statistically significant reduction in mean VAS scores in early postoperative period. In intergroup comparison, Paracetamol showed significantly lower VAS scores as compared to tramadol at 4 hour and 6 hour follow-up intervals during postoperative period. Subjects from tramadol group were more sedated compared to the paracetamol group. Complications like nausea and vomiting were more evident in tramadol group than paracetamol group. Conclusion: Though both the study drugs produce adequate postoperative analgesia, Paracetamol is safer and more effective analgesic than Tramadol when given intravenously in patient undergoing infra umbilical surgeries.
Authors and Affiliations
Arvind Yadav, Manohar Mane, Jyotsna Paranjpe
Keywords
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