COMPARATIVE STUDY OF EFFICACY AND SAFETY OF INTRAVENOUS PARACETAMOL VERSUS DICLOFENAC AS POSTOPERATIVE ANALGESIC IN LAPAROSCOPIC CHOLECYSTECTOMY
Pallavi Kainth* MBBS, Jarnail Singh MD and Rajesh Godara MS
ABSTRACT
Background: Laparoscopic Cholecystectomy is a common surgical procedure because of faster recovery time, less pain and lower post-operative morbidity. However, pain may remain severe in approximately 13% of patients even for one week after surgery which is the subject of main concern. Use of opioids, mainstay for pain management, is associated with significant adverse reactions. Non-Steroidal Anti Inflammatory Drugs (NSAIDs) may play an important role to substitute opioids for adequate pain control. Therefore the present study is done to compare the efficacy and safety of intravenous diclofenac and paracetamol. Materials & Methods: A single-blinded and comparative clinical study enrolled 80 patients randomized into two treatment groups. 40 patients in each group were administered either paracetamol or diclofenac infusion. Analgesic efficacy was assessed on Visual Analogue Scale (VAS) and Verbal Rating Scale (VRS) scale 6 hourly for one postoperative day along with safety assessment and need for rescue analgesia was also evaluated. Results: Visual Analogue Scale (VAS) score of paracetamol group was significantly lower than that of diclofenac group except for the first similar reading at 6 hours. Verbal Rating Scale (VRS) score of paracetamol group was lower throughout however, significant difference was observed at 12 and 18 hours. More patients in diclofenac arm required rescue analgesia than paracetamol arm. Both the drugs had similar safety profiles. Conclusion: Intravenous paracetamol infusion improves quality of analgesia by providing significant degree of pain relief and lessens requirement of rescue analgesics compared to intravenous diclofenac thus reducing the need of opiates use.
Keywords: Laparoscopic cholecystectomy, intravenous paracetamol, diclofenac, Visual Analogue Scale, Verbal Rating Scale.
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