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Analgesic Effects of Paracetamol and Morphine After Elective Laparotomy Surgeries

BACKGROUND: Opioids have been traditionally used for postoperative pain control, but they have some unpleasant side effects such as respiratory depression or nausea. Some other analgesic drugs like non-steroidal anti-inflammatory drugs (NSAIDs) are also being used for pain management due to their fe...

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Autores principales: Alimian, Mahzad, Pournajafian, Alireza, Kholdebarin, Alireza, Ghodraty, Mohammadreza, Rokhtabnak, Faranak, Yazdkhasti, Payman
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Kowsar 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013504/
https://www.ncbi.nlm.nih.gov/pubmed/24829880
http://dx.doi.org/10.5812/aapm.12912
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author Alimian, Mahzad
Pournajafian, Alireza
Kholdebarin, Alireza
Ghodraty, Mohammadreza
Rokhtabnak, Faranak
Yazdkhasti, Payman
author_facet Alimian, Mahzad
Pournajafian, Alireza
Kholdebarin, Alireza
Ghodraty, Mohammadreza
Rokhtabnak, Faranak
Yazdkhasti, Payman
author_sort Alimian, Mahzad
collection PubMed
description BACKGROUND: Opioids have been traditionally used for postoperative pain control, but they have some unpleasant side effects such as respiratory depression or nausea. Some other analgesic drugs like non-steroidal anti-inflammatory drugs (NSAIDs) are also being used for pain management due to their fewer side effects. OBJECTIVES: The aim of our study was to compare the analgesic effects of paracetamol, an intravenous non-opioid analgesic and morphine infusion after elective laparotomy surgeries. PATIENTS AND METHODS: This randomized clinical study was performed on 157 ASA (American Society of Anesthesiology) I-II patients, who were scheduled for elective laparotomy. These patients were managed by general anesthesia with TIVA technique in both groups and 150 patients were analyzed. Paracetamol (4 g/24 hours) in group 1 and morphine (20 mg/24 hours) in group 2 were administered by infusion pump after surgery. Postoperative pain evaluation was performed by visual analog scale (VAS) during several hours postoperatively. Meperidine was administered for patients complaining of pain with VAS > 3 and repeated if essential. Total doses of infused analgesics, were recorded following the surgery and compared. Analysis was performed on the basis of VAS findings and meperidine consumption. RESULTS: There were no differences in demographic data between two groups. Significant difference in pain score was found between the two groups, in the first eight hours following operation (P value = 0.00), but not after 12 hours (P = 0.14) .The total dose of rescue drug (meperidine) and number of doses injected showed a meaningful difference between the two groups (P = 0.00). Also nausea, vomiting and itching showed a significant difference between the two groups and patients in morphine group, experienced higher levels of them. CONCLUSIONS: Paracetamol is not enough for postoperative pain relief in the first eight hour postoperatively, but it can reduce postoperative opioid need and is efficient enough for pain management as morphine after the first eight hours following surgery.
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spelling pubmed-40135042014-05-14 Analgesic Effects of Paracetamol and Morphine After Elective Laparotomy Surgeries Alimian, Mahzad Pournajafian, Alireza Kholdebarin, Alireza Ghodraty, Mohammadreza Rokhtabnak, Faranak Yazdkhasti, Payman Anesth Pain Med Research Article BACKGROUND: Opioids have been traditionally used for postoperative pain control, but they have some unpleasant side effects such as respiratory depression or nausea. Some other analgesic drugs like non-steroidal anti-inflammatory drugs (NSAIDs) are also being used for pain management due to their fewer side effects. OBJECTIVES: The aim of our study was to compare the analgesic effects of paracetamol, an intravenous non-opioid analgesic and morphine infusion after elective laparotomy surgeries. PATIENTS AND METHODS: This randomized clinical study was performed on 157 ASA (American Society of Anesthesiology) I-II patients, who were scheduled for elective laparotomy. These patients were managed by general anesthesia with TIVA technique in both groups and 150 patients were analyzed. Paracetamol (4 g/24 hours) in group 1 and morphine (20 mg/24 hours) in group 2 were administered by infusion pump after surgery. Postoperative pain evaluation was performed by visual analog scale (VAS) during several hours postoperatively. Meperidine was administered for patients complaining of pain with VAS > 3 and repeated if essential. Total doses of infused analgesics, were recorded following the surgery and compared. Analysis was performed on the basis of VAS findings and meperidine consumption. RESULTS: There were no differences in demographic data between two groups. Significant difference in pain score was found between the two groups, in the first eight hours following operation (P value = 0.00), but not after 12 hours (P = 0.14) .The total dose of rescue drug (meperidine) and number of doses injected showed a meaningful difference between the two groups (P = 0.00). Also nausea, vomiting and itching showed a significant difference between the two groups and patients in morphine group, experienced higher levels of them. CONCLUSIONS: Paracetamol is not enough for postoperative pain relief in the first eight hour postoperatively, but it can reduce postoperative opioid need and is efficient enough for pain management as morphine after the first eight hours following surgery. Kowsar 2014-03-08 /pmc/articles/PMC4013504/ /pubmed/24829880 http://dx.doi.org/10.5812/aapm.12912 Text en Copyright © 2014, Iranian Society of Regional Anesthesia and Pain Medicine (ISRAPM); Published by Kowsar Corp. http://creativecommons.org/licenses/by/3.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Alimian, Mahzad
Pournajafian, Alireza
Kholdebarin, Alireza
Ghodraty, Mohammadreza
Rokhtabnak, Faranak
Yazdkhasti, Payman
Analgesic Effects of Paracetamol and Morphine After Elective Laparotomy Surgeries
title Analgesic Effects of Paracetamol and Morphine After Elective Laparotomy Surgeries
title_full Analgesic Effects of Paracetamol and Morphine After Elective Laparotomy Surgeries
title_fullStr Analgesic Effects of Paracetamol and Morphine After Elective Laparotomy Surgeries
title_full_unstemmed Analgesic Effects of Paracetamol and Morphine After Elective Laparotomy Surgeries
title_short Analgesic Effects of Paracetamol and Morphine After Elective Laparotomy Surgeries
title_sort analgesic effects of paracetamol and morphine after elective laparotomy surgeries
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4013504/
https://www.ncbi.nlm.nih.gov/pubmed/24829880
http://dx.doi.org/10.5812/aapm.12912
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