Paracetamol versus Diclofenac as Intravenous Post-Operative Analgesia in Patients after Laparoscopic Surgeries

Abstract

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. KEYWORDS Intravenous Paracetamol, Intravenous Diclofenac, Laparoscopic Surgeries, PostOperative Analgesia