Dr. Prutvi Shetty MBBS, Dr. Naseema V. Kanase MBBS DA M D. Anaes, Dr. V. K. Dhulkhed. M D Anaes, Sandhya Jagadale Msc. N, Kavita Kapurkar Msc. N
Abstract: This study entitled a randomized controlled study on effect of intravenous paracetamol as a pre-emptive analgesic in patients undergoing hysterectomy was carried out in Department of Anaesthesiology, Krishna Institute of Medical Sciences, Karad. It was a prospective, randomized, controlled, double blind clinical study involving 60 patients undergoing hysterectomy under Spinal Anaesthesia. The patients were randomly allocated in three groups of 20 patients each.the day of the surgery a morning dose of 5mg was given orally. The pre-operative pulse rate, blood pressure (systolic, diastolic and mean) and Spo2 were recorded. All patients received tablet Diazepam 10mg orally night before the surgery for anxiolysis and on As per the groups patients were given the drugs. The drug and the control were prepared in a burette by a colleague who was blinded to the study.The anaesthesiologist performed SAB and made observations in all patients involved in study. Intra-operatively mean arterial pressure (MAP), heart rate (HR), peripheral oxygen saturation (Spo2) was recorded. At the end of the operation, the patients were evaluated for post-operative pain with Visual Analogue Scale (VAS). Intravenous Fentanyl was administered when the visual analogue score was equal to or more than 4. VAS scores of patient at post-operative period 0min, 15mins and 30 mins and at 1, 2, 4, 8, 12 hours was recorded. The total fentanyl consumption during the same was recorded in micrograms (mcg).Side effects were also recorded.Result The three groups were comparable to each other with respect to all the demographic data like Age, Weight, Height, Duration of surgery, The average post-operative VAS scores in the three groups was significant, The pain scores in Group I (Pre-emptive Group) was less than Group II (Intra-operative Group) and also Group II was less than Group III ( saline control Group), The average fentanyl consumption in the Pre-emptive Group was significantly less than Group II and III. However Group II patients who received paracetamol before the skin closure needed significantly less opioid than Group III patients, Incidence of nausea and vomiting was less in Pre-emptive Group compared to the Group II patients which was also lesser than Group III patients.
Keywords: Intra-venous paracetamol, pre-emptive analgesic and post-operative pain management