I.V. paracetamol [perfalgan] infusion for postoperative analgesia after laparoscopic cholecystectomy

ABSTRACT

The adequacy of postoperative laparoscopic cholecystectomy pain control is one of the most important factors in determining when a patient can be safely discharged from the outpatient facility. The purpose of this study was to compare the quality of analgesia and side effects of intravenous paracetamol [perfalgan] 1 g versus intravenous meperidine 100 mg for postoperative analgesia after ambulatory laparoscopic cholecystectomy. The study comprised eighty patients, ASA physical status I or II, age 20-60 years, undergoing elective cholecystectomy under general anesthesia at Benha University Hospital. Before the end of the operation and after removal of the gall bladder, patients were randomly allocated to one of two equal groups, [Group 1] patients received 1g/100ml I.V. paracetamol [Perfalgan] in 15 minutes and [Group 2] patients received 100 mg meperidine [pethidine] I.V. in 15 minutes. Most of the patients [72.5%] in paracetamol group had a VAS Score more than five at six hour after the operation. But in meperidine group [Group 2] the pain intensity increases after 15 minutes and made a peak level in the second hour after the operation. Patients with a VAS score more than five a rescue analgesic was given to the patient. The time to the first request for supplemental analgesia after injection of the study drugs was approximately three times longer in the paracetamol compared with meperidine. Total analgesic consumption 24 hours postoperatively was higher in meperidine group. 16 [40%] of patients in meperidine group [Group 2] were taken three doses of rescue analgesic but 12 [30%] of patients in paracetamol group [Group 1] take three doses of rescue analgesics. 10 [25%] patients in meperidine and 6 [15%] in paracetamol group had nausea. No respiratory depression, vertigo, ataxia, itching, somnolance and headache was observed. Our results indicate that iv paracetamol 1g has better analgesic potency and less side effects than 100 mg meperidine for postoperative analgesia after ambulatory laparoscopic cholecystectomy