Preemptive Analgesia with Intravenous Paracetamol for Post-Cesarean Section Pain Management: A Prospective, Randomized, Controlled Trial
Ozlem Ozmete1, Cagla Bali1, Oya Yalcın Cok1, Pinar Ergenoglu1, Nesrin Bozdogan Ozyilkan1, Sule Akin1, Hakan Kalayci2, Anis Aribogan1
1Anesthesiology and Reanimation Department, Baskent University School of Medicine, Adana/TURKEY
2Obstetrics and Gynecology Department, Baskent University School of Medicine, Adana/TURKEY
Abstract Background and OBJECTIVES: Pain is the most common acute postoperative complaint after cesarean delivery. In this prospective, randomized, double-blind, controlled study, our aim was to evaluate the analgesic effect of preemptive single dose intravenous paracetamol on postoperative pain and analgesic consumption within 24 hours after elective cesarean surgery. METHOD: American Society of Anesthesiologists (ASA) I and II 60 patients between 18-40 years of age who were scheduled to undergo elective cesarean section. Patients were randomized into two groups to receive either intravenous 1 g paracetamol (100 ml) (Group P) or 0.9 % NaCl solution (100 ml) (Group C) 15 minutes before the induction of general anesthesia. After delivery of newborn 0.15 mg kg-1 morphine was administered to all patients in both groups. Postoperative analgesia was provided with patient-controlled intravenous analgesia with morphine in the postoperative period. Pain which is the primary outcome measure was assessed at 15th, 30th minutes, 1th, 2th, 4 th, 6th, 12th, 24th hours by the visual analogue scale. Patients’ demographics, hemodynamics, Apgar score, additional analgesic requirement, side effects, patients’ satisfaction and postoperative total morphine consumption within 24 hours were recorded. RESULTS: Median visual analogue scale for pain in Group P were significantly lower compared to Group C at all time points postoperatively (p < 0.05). Additional analgesic requirement during postoperative first hour was lower in Group P (p < 0.05). Total morphine consumption was higher in Group C compared with Group P (p < 0.05). There was no difference between groups with respect to Apgar scores, side effects and patient satisfaction (p > 0.05). CONCLUSIONS: Preemptive use of single-dose intravenous 1 g paracetamol was found to be effective in reducing the severity of pain and opioid requirements within 24 hours after cesarean section.
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