Preoperative Paracetamol Improves Post-Cesarean Delivery Pain Management: A Prospective, Randomized, Double-Blind, Placebo-Controlled Trial

Abstract

Study Objective: To evaluate the analgesic effect of preoperative single dose intravenous paracetamol on postoperative pain and analgesic consumption within 24 hours after elective cesarean surgery.

Design: Prospective, randomized, double-blind, placebo-controlled clinical trial.

Setting: University Teaching Hospital.

Patients: American Society of Anesthesiologists (ASA) I and II 60 patients between 18-40 years of age who were scheduled to undergo elective cesarean section.

Interventions: Patients were randomized into two groups to receive either intravenous 1 g paracetamol (100 mL) (Group P) or 0.9% NaCl solution (100 mL) (Group C) 15 minutes before the induction of general anesthesia. After delivery of newborn 0.15 mg kg(-1) morphine was administered to all patients in both groups. Postoperative analgesia was provided with patient-controlled intravenous analgesia with morphine in the postoperative period.

Measurements: Pain which is the primary outcome measure was assessed at 15th, 30th minutes and 1st, 2nd, 4th, 6th, 12th, 24th hours by the Visual Analogue Scale. Patients' demographics, hemodynamics, Apgar score, additional analgesic requirement, side effects, patients' satisfaction and postoperative total morphine consumption within 24 hours were recorded.

Main Results: Median visual analogue scale for pain in Group P was significantly lower compared to Group C at all time points except for the score at 24th h postoperatively (P <.05). Additional analgesic requirement during postoperative first hour was lower in Group P (P <.05). Total morphine consumption was higher in Group C compared with Group P (P <.05). There was no difference between groups with respect to Apgar scores, side effects, and patient satisfaction (P >.05).

Conclusions: Preoperative use of single-dose intravenous 1 g paracetamol was found to be effective in reducing the severity of pain and opioid requirements within 24 hours after cesarean section. (C) 2016 Elsevier Inc. All rights reserved.