Role of Paracetamol Nefopam in Immediate Postoperative Analgesia for Laparoscopic Cholecystectomy: single center

Abstract

Ali Najeh Al-Awwady, Ali Nima Hasan, Wisal Abdul-Mahdi Kadhim

Background: Despite the fact that it's significantly less than that for open procedure. As such pain is multimodal, so the use of drugs that act by different mechanisms is expected to be more effective. Objectives: We evaluated the effect of intravenous Paracetamol on postoperative pain in patients undergoing laparoscopic cholecystectomy. Patients and Method: This is a randomized single center study for 80 patients were selected among those presented for elective laparoscopic cholecystectomy from august 2017 to January 2018. Preoperatively, complete medical history was recorded, detailed physical examination performed and laboratory investigations assessed. The standard monitoring is non-invasive blood pressure, pulse rate, O2 saturation, ECG and capnography were applied. The patients were monitored continuously from the time just before induction of anesthesia until discharge from the post anesthetic care unit (PACU), while the study variables were recorded every 5 minute intervals. Drugs side effects are also observed. All groups received Paracetamol i.v infusion started with the induction of general anesthesia. Group A received placebo, group B received Nefopam, while group C received Tramadol by slow i.v injection. The researcher was responsible for patient allocation into the Specified groups and the preparation of the drugs under study. Neither the anesthesiologist nor the patient knew which drug was administered.
Results: Postoperatively, the pain score was significantly lower in group B (Nefopam group) than groups A and C (P value <0.001). Similarly, the effect size for group B is significantly lower in group B (0.28) than group A (0.95) and group C (0.9) (P value 0.025). All the other variables observed were not significantly different among all of the three studied groups. No patient suffered from side effect of any of the study drugs. Conclusion: Intraoperative Paracetamol Nefopam combination is more effective in relieving immediate postoperative.