Preventive Effects of Intravenous Paracetamol in Post-Partum Pain of Elective Cesarean Delivery with Spinal Anesthesia

Document Type : Original Article (s)

Authors

1 Associate Professor, Department of Anesthesiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

2 Student of Medicine, School of Medicine AND Student Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Concerning the importance of pain control after cesarean section delivery taking pain analgesic to reduce post-surgery pain is important. The aim of this study was evaluating the preventive effect of intravenous paracetamol in postpartum pain of elective cesarean delivery with spinal anesthesia.Methods: In this double-blinded clinical trial study, nulliparous pregnant women admitted to Shahid Beheshti hospital, Isfahan, Iran, for elective caesarean section in 2012 were included. 70 nulliparous women were randomly assigned and divided into two groups of 35. The patient was anesthetized in a sitting position, at the level of L3-L4.. Patients (case group) received 1 g paracetamol in 100 ml normal saline or (control group) 100 ml normal saline, in 20 minutes via injecting. The sedation score, pain (visual analogue scale), heart rate, mean amount of used analgesic (pethedine), mean, systolic and diastolic blood pressure, nausea and vomiting were observed and recorded during the surgery and recovery eah 15 minutes till 1 hour and then hourly for 24 hours after the operation in ward. For quantitative variables, Mann-Whitney and independent-t tests were used for statistical analysis.Findings: During the sugery, the incidence of vomiting and the pain were not significantly different in any time between the two groups. The mean heart rate at the 0 and 5th minutes, during the surgery, was not significantly different; but at the 15th, 30th and 45th minutes, the mean heart rate was significantly higher in the control group (P < 0.001). In recovery, at the 0, 15th, 45th and 60th minutes, the pain was significantly lower among the case group (P < 0.001). But, there was no significant difference at the 30th minute. Patient satisfaction was not significantly different in the case and control groups.Conclusion: The findings of this study indicate that the use of intravenous paracetamol is effective in reducing postoperative pain and reduces the need for drugs.

Keywords

References

  1. Gibbs RS. Danforth's obstetrics and gynecology. Philadelphia, PA: Lippincott Williams and Wilkins; 2008. p. 425-53.
  2. Nichols DH, Clarke-Pearson DL. Gynecologic, obstetric, and related surgery. 2nd ed. Boston, MA: Mosby; 2000.
  3. Miller RD. Anesthesia. 6th ed. Philadelphia, PA: Churchill Livingstone; 2014.
  4. Jabalameli M, Aram S, Shahbazi M, Parvaresh M, Taheri S. Comparison of intranasal versus intravenous pethidine for pain relief after cesarean section. Zahedan J Res Med Sci 2011; 13(6): 8-12. [In Persian].
  5. Cunningham FG. Williams obstetrics. 22th ed. New York, NY: McGraw Hill Professional; 2005.
  6. Munishankar B, Fettes P, Moore C, McLeod GA. A double-blind randomised controlled trial of paracetamol, diclofenac or the combination for pain relief after caesarean section. Int J Obstet Anesth 2008; 17(1): 9-14.
  7. Birnbach DJ, Browne IM. Anesthesia for obstetrics. In: Miller RD, Editor. Miller's Anesthesia. 6th ed. London, UK: Churchill Livingstone; 2010. p. 1217.
  8. Hassani V, Manochehripour M, Nojoomi M. Study of the Effects of Intravenous Paracetamol with Different Doses on Opioid Sparing during and after Upper Limb Surgeries. Razi j Med Sci 2008; 15(58): 109-15. [In Persian].
  9. Arab M, Manouchehrian N, Khatibian P, Nikoseresht M. The effect of bupivacaine infiltration on post cesarean section pain, nausa and vomiting in patients under spinal anesthesia. Sci J Hamdan Univ Med Sci 2006; 13(2): 18-22. [In Persian].
  10. Akhlaghi F, Alipour T. Comparison of suppository diclofenac and oral acetaminophen codeine in pain relief after episiotomy. Iran J Obstet Gynecol Infertil 2010; 13(5): 20-4. [In Persian].
  11. Liu K, Hsu CC, Chia YY. Effect of dexamethasone on postoperative emesis and pain. Br J Anaesth 1998; 80(1): 85-6.
  12. Alhashemi JA, Alotaibi QA, Mashaat MS, Kaid TM, Mujallid RH, Kaki AM. Intravenous acetaminophen vs oral ibuprofen in combination with morphine PCIA after Cesarean delivery. Can J Anaesth 2006; 53(12): 1200-6.
  13. Kardash KJ, Sarrazin F, Tessler MJ, Velly AM. Single-dose dexamethasone reduces dynamic pain after total hip arthroplasty. Anesth Analg 2008; 106(4): 1253-7, table.
  14. Kilicaslan A, Tuncer S, Yuceaktas A, Uyar M, Reisli R. The effects of intravenous paracetamol on postoperative analgesia and tramadol consumption in cesarean operations. Agri 2010; 22(1): 7-12.
  15. van der Marel CD, Peters JW, Bouwmeester NJ, Jacqz-Aigrain E, van den Anker JN, Tibboel D. Rectal acetaminophen does not reduce morphine consumption after major surgery in young infants. Br J Anaesth 2007; 98(3): 372-9.
  16. Hahn TW, Mogensen T, Lund C, Jacobsen LS, Hjortsoe NC, Rasmussen SN, et al. Analgesic effect of I.V. paracetamol: possible ceiling effect of paracetamol in postoperative pain. Acta Anaesthesiol Scand 2003; 47(2): 138-45.
Journal of Isfahan Medical School
Volume 32, Issue 296 - Serial Number 296
July and August 2014
Pages 1227-1237

Files

History

  • Receive Date: 15 May 2013
  • Revise Date: 02 May 2024
  • Accept Date: 06 April 2022

Share

How to cite

Statistics