Comparative Evaluation of Effectiveness of Intravenous Paracetamol and Intravenous Diclofenac as Post-operative Analgesia in Laparoscopic Cholecystectomy

Authors

  • Kalpana Kharbuja Kathmandu University School of Medical Sciences, Dhulikhel, Nepal https://orcid.org/0000-0002-6127-5556
  • Mahesh Sharma Lumbini Medical College Teaching Hospital, Palpa, Nepal
  • Nil Raj Sharma Lumbini Medical College Teaching Hospital, Palpa, Nepal

Keywords:

Diclofenac, Laparoscopic Cholecystectomy, paracetamol, post-operative analgesia, Visual Analogue Scale (VAS)

Abstract

Introduction: Though the development of minimally invasive surgery  has revolutionized the field of surgery,  post-operative pain is still a significant issue. Unlike in the past, concerns about adverse effects have limited the role of opioids in post-operative pain management. This study aims to compare the effectiveness of intravenous paracetamol and  diclofenac as postoperative analgesia in laparoscopic cholecystectomy.

Methods: One hundred and twenty eight patients of American Society of Anesthesiologists (ASA) categories I and II  included in this study  were divided into two groups. Anesthesia induction and maintenance were standardized. The first group received 15mg/kg (maximum 1gm) intravenous paracetamol and the second group received 2mg/kg (maximum 75mg) intravenous diclofenac 30 minutes prior to ending of surgery. A questionnaire was responded by patients and chart was maintained by visual analogue scale. Mann Whitney U test was used to analyze quantitative data and Chi-square test for categorical data. P value <0.05 was considered statistically significant.

Results:  Profiles of hemodynamic changes were almost similar in both groups with respect to heart rate and blood pressure. However, paracetamol infusion provided hemodynamic stability in post-operative period. We observed statistically significant differences  in visual analogue scale between the two groups. Most of the patients in paracetamol group had low mean pain scores in post-operative period and provided an extended analgesia compared to diclofenac. No serious postoperative complication was observed in  paracetamol group.

Conclusion: Administration of intravenous paracetamol has better and prolonged analgesic effect  with low mean pain score and less requirement for rescue analgesia compared to diclofenac.

DOI: https://doi.org/10.22502/jlmc.v6i2.248

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Author Biographies

Kalpana Kharbuja, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal

Lecturer, Department of Anesthesia and Critical Care

Mahesh Sharma, Lumbini Medical College Teaching Hospital, Palpa, Nepal

Assistant Professor, Department of Anesthesia and Critical Care

Nil Raj Sharma, Lumbini Medical College Teaching Hospital, Palpa, Nepal

Professor and Head, Department of Anesthesia and Critical Care

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Published

2018-11-03

How to Cite

Kharbuja, K., Sharma, M., & Sharma, N. R. (2018). Comparative Evaluation of Effectiveness of Intravenous Paracetamol and Intravenous Diclofenac as Post-operative Analgesia in Laparoscopic Cholecystectomy. Journal of Lumbini Medical College, 6(2). Retrieved from https://www.nepjol.info/index.php/JLMC/article/view/23657

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Section

Original Research Articles