Intravenous Administration of Propacetamol Reduces Morphine Consumption After Spinal Fusion Surgery

Hérnández-Palazón, J; Tortosa, J. A.; Martínez‐Lage, Juan F.; Pérez‐Flores, Domingo

doi:10.1097/00000539-200106000-00024

Cited by 143 publications

(97 citation statements)

References 22 publications

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“…Our study is in agreement with the study of Joaquin Hernandez-Palazon et al (2001), 27 who demonstrated the usefulness of propacetamol as an adjunct to PCA morphine in the treatment of postoperative pain after spinal fusion.…”

Section: Discussionsupporting

confidence: 93%

Study of Preemptive Ana L Gesic Effects of Intravenous Paracetamol in Reducing Doses of Morphine in Patients Undergoing Laparoscopic Cholecystectomy

Khan¹,

Sofi²,

Munshi³

et al. 2015

jemds

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ABSTRACT:Paracetamol is primarily thought to be a cyclo-oxygenase inhibitor acting through central nervous system. Indirect effects of paracetamol are through serotonergic system as a nonopioid analgesic. We studied intravenous paracetamol 1 gram preoperatively to assess its intraoperative and post-operative analgesic effects, in reducing intraoperative morphine requirements, to reduce the requirement of postoperative analgesia, enable early recovery from anaesthesia and to reduce postoperative nausea and vomiting. One hundred patients from either sex classified in ASA Class I and II scheduled for laparoscopic cholecystectomy were randomly allocated into two groups of 50 patients each. Group I (Study group) received paracetamol 1 gram infusion prior to induction with 50µg/kg morphine diluted with normal saline to a total volume of 5ml. Group II (Control group) received l00µg/kg morphine diluted with normal saline to a total volume of 10ml at induction. We observed that there was significant increase in mean time for rescue analgesia from induction of anaesthesia in Group I (study group) was 11.25±1.827 hours and Group II (Control group) was 6.98±4.568 hours (p value < 0.001). The median value of visual analogue score was lower at all-time points in group I when compared to group II at each interval and it was statistically significant (p value < 0.001). A significant decrease in mean number of administered doses of rescue analgesia during 24 hours was seen in the study group (0.52±0.505) as compared to the control group (1.3±0.463) with a p value of < 0.001. Mean modified Aldrete score in the study group was 9.78±0.465 and in control group it was 8.1±1.15. It was statistically significant p value of <0.001. The mean number episodes of nausea and vomiting in group I were 0.74±0.633 and in group II 0.94±0.652 and was statistically insignificant with p value of 0.361. CONCLUSION: Administration of intravenous paracetamol and 50% doses of morphine prior to induction in patients undergoing laparoscopic cholecystectomy ensures effective analgesic intra-operatively as well as postoperatively and was associated with earlier discharge from post anaesthetic care unit when compared with full doses of IV morphine, however above combination was not able to decrease significantly reduction in morphine related adverse effects in these patients.

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Section: Discussionsupporting

confidence: 93%

Study of Preemptive Ana L Gesic Effects of Intravenous Paracetamol in Reducing Doses of Morphine in Patients Undergoing Laparoscopic Cholecystectomy

Khan¹,

Sofi²,

Munshi³

et al. 2015

jemds

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“…Studies of combination treatment showed that paracetamol has an opioid-reducing effect and that it significantly reduces the patient's need for total opioids, thereby increasing the patient's overall satisfaction with the analgesic therapy (10,13). In the current study, we found Data are presented as means ± SD or as absolute numbers.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the analgesic effects of paracetamol and tramadol in lumbar disc surgery

Yılmaz¹,

Sarihasan²,

Kelsaka³

et al. 2015

Turk J Med Sci

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IntroductionDespite developments in the pathophysiology and treatment of pain, increased knowledge of pain management, the availability of new drugs, and complex drug delivery systems, the pain management of many patients after surgery remains inadequate. Studies have shown that successful postoperative analgesia after surgery prevents many side effects of pain, such as the inability to breathe at ease, the increase in the workload of the cardiovascular system, the development of thromboembolic events due to a delay in the mobilization of patient, and the increase in stress response due to the activation of the sympathetic nervous and neuroendocrine systems (1,2). Inadequate treatment of acute pain is the most common cause of chronic pain after surgery. The aim after surgery is to ensure that organ functioning returns to normal quickly by controlling pain as soon as possible (3).Today it is possible to achieve successful postoperative analgesia by selecting appropriate methods/routes of administration, agents, dosages, and dosage ranges. Opioids are the most widely used group of drugs in the treatment of postoperative pain due to their strong analgesic activities. However, opioid-related nausea, vomiting, pruritus, urinary retention, respiratory depression, sedation, and central nervous system depression have accelerated the search for analgesic drugs with better pain relief efficacy and fewer side effects (4).Research has reported gastric irritation, erosion, bleeding, and inhibition of platelet aggregation with nonsteroidal antiinflammatory drugs (NSAIDs), in addition to adverse effects on the secretion of uric acid and bleeding (5), thereby restricting their use. Side effects, such as systemic toxicity and prolonged sensory and motor responses, have also been reported with local anesthetic drugs used to provide pain control (6). Tramadol, a weak, effective synthetic opioid, has been shown to have relatively few side effects compared to other opioids, and its abuse or addiction potential is negligible (7). Paracetamol is a Background/aim: To compare the postoperative analgesic efficacy and side effects of paracetamol and tramadol in patients undergoing lumbar disc surgery. Materials and methods: Group P (paracetamol group) was given 1 g of paracetamol intravenously 30 min before the end of the operation and 1 g each day at 6-h intervals. Group T (tramadol group) was given 1.5 mg/kg of tramadol as a loading dose and patient-controlled analgesia for 1 day. Hemodynamic parameters, modified Aldrete score, Ramsay sedation scale score, patient satisfaction scale (PSS) score, visual analog scale (VAS) score, nausea/vomiting scale score, and additional analgesic needs/times were recorded.Results: PSS scores were significantly higher in Group T (P < 0.05). The total analgesic consumption was significantly higher in Group P. There were no significant differences in the VAS scores at any time points. Twenty-one patients in Group P and 8 patients in Group T needed additional analgesia (P < 0.05). The first additional analg...

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“…Based on the literature intravenous paracetamol is mostly used in settings of post-operative pain management (20,(24)(25)(26)(27). In a study by Moller et al, it was tried to compare the analgesic efficacy and safety of a single intravenouse infusion of 1 gram of acetaminophen with propacetamol 2 gram (a pro drug form of paracetamol) and placebo in patients with moderate-to-severe pain after third molar surgery.…”

Section: Discussionmentioning

confidence: 99%

Paracetamol vs. Intravenous Morphine Plus Diclofenac in Renal Colic Pain: A Randomized Clinical Trial

et al. 2018

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Background: Renal colic is one of the most prevalent diagnoses made in emergency departments. Main medications used to relieve renal colic is opioids and non-steroidal anti-inflammatory drugs (NSAID). As far as these medications may have some side effects, researchers have always focused on proposing analgesics with more efficacy and less side effects. In the present study, it was tried to compare paracetamol and intravenous morphine plus diclofenac in renal colic.

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Intravenous Administration of Propacetamol Reduces Morphine Consumption After Spinal Fusion Surgery

Cited by 143 publications

References 22 publications

Study of Preemptive Ana L Gesic Effects of Intravenous Paracetamol in Reducing Doses of Morphine in Patients Undergoing Laparoscopic Cholecystectomy

Study of Preemptive Ana L Gesic Effects of Intravenous Paracetamol in Reducing Doses of Morphine in Patients Undergoing Laparoscopic Cholecystectomy

Comparison of the analgesic effects of paracetamol and tramadol in lumbar disc surgery

Paracetamol vs. Intravenous Morphine Plus Diclofenac in Renal Colic Pain: A Randomized Clinical Trial

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