COMPARISON OF INTRAVENOUS PARACETAMOL AS PREEMPTIVE AND PREVENTIVE ANALGESIC IN PATIENTS UNDERGOING PYELOLITHOTOMY: A PROSPECTIVE, RANDOMISED DOUBLE BLIND, COMPARATIVE STUDY

Dr. Indira Kumari, *Dr. Vikas Sharma, Dr. Udita Naithani, Dr. Sandeep Sharma, Dr. Charu Sharma and Dr. Ankush Garg

ABSTRACT

Aim and objectives: Aim of this study is to compare the effects of intravenous paracetamol as: Pre-emptive analgesic and Preventive analgesic as regards to hemodynamics, pain control and duration of analgesia in patients undergoing pyelolithotomy under general anaesthesia. Patients and methods: 60 patients randomised in two groups undergoing pyelolithotomy under general anaesthesia. In Group Pe, intravenous paracetamol, 1 g was administered over 15-20 minutes, 30 minutes prior to induction of anaesthesia as pre-emptive analgesia and 100 ml NS (placebo) was given over 15-20 minutes, 30 minutes prior to completion of surgery. In Group Pv, 100 ml NS (placebo) was given over 15-20 minutes, 30 minutes prior to induction of anaesthesia and intravenous paracetamol, 1 g was administered over 15-20 minutes, 30 minutes prior to completion of surgery as preventive analgesia. Intraoperative vitals, intraoperative fentanyl, postoperative vitals and VAS score was noted and compared. Results: Pre-emptive paracetamol contributed to intraoperative analgesia leading to better control of hemodynamics in intraoperative period and it also provided early postoperative analgesia (around 1.25 hr). Preventive paracetamol is better in terms of providing longer duration of postoperative analgesia (around 4 hr), but it requires additional opioid administration during intraoperative period to supplement analgesia for better hemodynamic stability. Conclusions: In our opinion, iv paracetamol should be better administered pre-emptively, because of its advantage of providing analgesia during intraoperative as well as early postoperative period.

Keywords: Pyelolithotomy, Paracetamol, Pre-emptive analgesic, Preventive analgesic.