Comparative study of analgesic effect of paracetamol infusion versus intramuscular tramadol injection after gynaecological surgeries: A prospective randomised clinical trial

Abstract

Background: Postoperative pain inadequately treated result in suffering, as well as multiple physiological and psychological consequences which may adversely affect perioperative outcomes and contribute to increased length of stay. Paracetamol a NSAID is an Analgesic and Antipyretic agent. Tramadol an Opioid, has been shown to provide effective analgesia after both intramuscular and intravenous administration for the treatment of postoperative pain. This prospective study is to compare the Analgesic efficacy of intravenous paracetamol and intramuscular tramadol postoperatively. Aims and Objectives: To compare the effect of Paracetamol infusion versus intramuscular Tramadol injection as post operative analgesia after gynaecological surgeries over 48 hours. 1. To compare patients’ demand for analgesia and VAS score at different period of time over 48 hours. 2. To compare the number of doses given over 48 hours including the Rescue Analgesia given in less than 6 hours interval between doses 3. To compare the number of rescue analgesia needed in between the 6 hours interval between doses. Methods: The study was conducted in the Department of Obstetrics and Gynaecology, Rajah Muthiah Medical College and Hospital, Annamalai University, Chidambaram from October 2018 – October 2019 in Gynaecological patients undergoing surgery selecting patients as per the Predetermined Inclusion and Exclusion criteria. and Postoperatively, the calculated doses of, in Group A (n=30) Paracetamol infusion and in Group B (n=30) Intramuscular Tramadol injection, given using Visual Analogue Scale (VAS) score for assessment of pain intensity Results: Number of Patients Demand for Analgesia had a Significant (p-value=0.01) difference when VAS score >/=4 denoting less number of Demand in Group A. The total number of doses needed over 48 hours was less in Group A. The number of Rescue Analgesia needed in both groups had no Statistical difference. Also, the need for another drug was significantly less in Group A. Also, in all cases in Group B another drug was used as rescue analgesia but none in group a needed another drug as rescue analgesia. No PONV (Post operative nausea and vomiting) in Group A against 63.3% in Group B. Conclusions: Paracetamol infusion is an effective and even superior post operative analgesic and safer alternative to intramuscular tramadol injection post operatively.