Malaya Kumar Patel, Mahendra Ekka, Sheela Ekka, Harekrishna Dalai, Pragyan S.P. Pujahari
BACKGROUND Effective pain management is an important component of intra and post-surgical care. In untreated cases it could lead to chronic postoperative pain after surgery. Lack of proper analgesia may cause the patients to hypo ventilate, thereby causing the reduction in vital capacity and other lung functions. A Concept of Preemptive analgesia involves application of treatment prior to trauma and surgical intervention to prevent central sensitization of pain pathways that reduces the amount of analgesic requirements. This results in reduced morbidity and shorter duration of hospital stay. The aim of this study was to compare the effects of I.V. paracetamol and diclofenac aqua as preemptive analgesia in laparoscopic cholecystectomy. MATERIALS AND METHODS This prospective, randomized, double blinded study was conducted in a tertiary care hospital. Total of 100 patients posted for laparoscopic surgery were included and randomly allocated into two groups (50 in each group), Group-D and Group-P. Group D- Patients received diclofenac aqua 75 mg (infusion) in 100 ml NS 15 minutes before induction. Group P- Patients received I.V. paracetamol 1 gm (infusion) in 100 ml NS 15 minutes before induction. VAS score, PR, SBP, DBP, RR were recorded at 15 minutes, 30 minutes, 1 hour, 2 hours, 4 hours, 8 hours & 12 hours after surgery. The data were compiled and expressed as mean ± standard deviation (SD) and percentages. Statistical software SPSS (version 20.0) was used to carry out the statistical analysis of data. RESULTS Although diclofenac aqua was significantly better analgesic option in comparison to I.V. paracetamol in early post-operative period; the overall efficacies of both drugs were comparable post 4 hours of extubation. The time at which rescue analgesia was given was early in the paracetamol group. However, the differences in both groups were not statistically significant. While comparing the hemodynamic parameters no significant differences found. However respiratory rate was significantly higher in paracetamol group. CONCLUSION Both drugs are safe while diclofenac aqua is slightly better in controlling post-operative pain in comparison to I.V. paracetamol. However, both drugs can be used in Indian patients, depending on cost and availability.
