Ashwanth Bagavannathan Adiththan1, Ramya Natarajan2, Sanmuga Piriya Krishnan3, Suneeth P. Lazarus4
BACKGROUND
Laparoscopic surgery is becoming a widely used procedure in recent days due to
its minimal invasive nature and faster recovery. Pain is a stressful stimulus in postoperative
period. Pain is a subjective experience. Poor pain management may
hinder better postoperative outcome, leading to patient suffering and lengthened
recovery period. We wanted to compare the efficacy of intravenous paracetamol
and intravenous diclofenac for post-operative analgesia following laparoscopic
surgeries.
METHODS
This randomised controlled double-blind prospective study was conducted
between October 2017 and May 2019 among 48 participants posted for
laparoscopic abdominal surgeries, block randomised into 24 participants each in 2
groups. All patients were given general anaesthesia and 30 minutes prior to
extubation patients were given the test drug according to the groups assigned
using closed envelop technique. The test drugs were continued post operatively
at prescribed intervals. Visual analogue score (VAS) score, systolic and diastolic
blood pressure (BP) and heart rate were monitored at 2, 4, 6, 12 and 24 hours
postoperatively. Furthermore, need for rescue analgesia with inj. tramadol 50 mg
intramuscular (IM) and post-operative nausea and vomiting (PONV) were noted.
RESULTS
The study results showed increased pain scores in diclofenac group up to 12 hours
but were statistically insignificant. High pain score was seen in diclofenac group at
24 hours with statically significant P-value of 0.022 and PONV occurring in 3
patients. Paracetamol group had better haemodynamic stability.
CONCLUSIONS
Intravenous paracetamol and intravenous diclofenac were found to be equally
effective in post-operative analgesia in patients undergoing laparoscopic surgeries;
however, paracetamol has an advantage of providing better analgesia for longer
duration with better haemodynamic stability.
