Preventive Analgesia with Intravenous Paracetamol for Post-cesarean section Pain Control

Atashkhoyi, Simin; Rasouli, Sousan; Fardiazar, Zahra; Ghojazadeh, Morteza; Marandi, Pouya Hatami

doi:10.15296/ijwhr.2014.20

Cited by 8 publications

(11 citation statements)

References 20 publications

(22 reference statements)

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“…The present findings demonstrated that the injection of paracetamol prior to the end of surgery effectively suppressed all possible nociceptor transduction pathways, preventing central sensitization and improving postoperative pain management (5,19,22). In our previous study, we also observed the efficacy of preventive analgesia with paracetamol 1 g in postoperative pain after cesarean section (18).…”

Section: Discussionsupporting

confidence: 73%

“…Preventive analgesia was considered to be a suitable definition for both the intraoperative administration of drug and its administration at the end of the surgery for preventing postoperative pain (18). The present findings demonstrated that the injection of paracetamol prior to the end of surgery effectively suppressed all possible nociceptor transduction pathways, preventing central sensitization and improving postoperative pain management (5,19,22).…”

Section: Discussionmentioning

confidence: 51%

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Effect of Different Doses of Paracetamol on Postoperative Pain After Gynecologic Laparoscopy

Atashkhoei¹,

Nikan²,

Kardan³

et al. 2018

International Journal of Women’s Health and Reproduction Scienc

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Introduction Laparoscopic surgery is a minimally invasive technique associated with less postoperative pain. However, laparoscopic procedures are associated with moderate to severe postoperative pain, frequently in abdomen or shoulder regions in most patients, particularly on the first postoperative day. Studies show that 80% of patients require systemic opioid analgesia after laparoscopic surgery (1,2). Different approaches have been recommended for the treatment of postoperative pain. Systemic, local, and neuraxial medications (as preemptive, preventive, or postoperative administration) are the commonly used modalities for postoperative pain relief (3-5). However, they may not completely relieve postoperative pain, and/ or have the potential for debilitation and serious adverse reactions (3-8). Paracetamol is used as a supplemental analgesic or single modality to reduce postoperative pain. Paracetamol takes both central inhibitor action on cyclooxygenases (cox-3) and interaction with the serotonergic system. In addition, paracetamol is a weak cox-1 and cox-2 inhibitor (anti-inflammatory effect). Moreover, paracetamol does not have the adverse effects of nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids (9-12). Paracetamol (intravenous acetaminophen) is a nonopioid analgesic which is devoid of risks related to opioids (10). The usage of paracetamol after various surgical procedures in decreasing acute pain has been shown (11,12). The mechanism of action is not completely understood; it is thought to act through the inhibition of prostaglandin synthetase in the CNS (13). The combination of paracetamol with other analgesics working on different pain mechanisms may be an improvement in postoperative analgesia and reduction of side effects (9). The recommended dose for paracetamol in adults is 1 g, which can be administered every 6 hours per day (14). There are conflicting results concerning the analgesic effect of paracetamol 1 g in postoperative pain control, especially severe pain. Likewise, there is limited information on using a high starting dose of paracetamol for postoperative pain control (15-17). In addition, no other study on the preventive administration of larger doses of paracetamol for the management of laparoscopic pain is available. In a previous study, we found advantages of administration of 1 g of paracetamol at the end of surgery (preventive analgesia) in the patients undergoing cesarean section (18). Thus, this study was designed to evaluate the analgesic efficacy and opioid-sparing activity of 2 g of paracetamol compared with 1 g at the end of Abstract Objectives: This study aimed to investigate the analgesic efficacy and safety of preventive administration of 2 g of paracetamol compared with 1 g for the management of postoperative pain in the patients undergoing gynecologic laparoscopic procedures. Methods and Materials: This double-blind study was conducted on 92 women who were randomly assigned into two groups: paracetamol 2 g (study group; n=46) and 1 g (control group; n=46) into 10...

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Section: Discussionsupporting

confidence: 73%

Section: Discussionmentioning

confidence: 51%

Effect of Different Doses of Paracetamol on Postoperative Pain After Gynecologic Laparoscopy

Atashkhoei¹,

Nikan²,

Kardan³

et al. 2018

International Journal of Women’s Health and Reproduction Scienc

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“…5 They are secreted into the breast milk which leads to sedation and respiratory depression in newborn infants. 5,6,7 Paracetamol being a non-opioid analgesics is devoid of the potential risks of opioids. 7 It has an established record of safety, efficacy and tolerance in adults.…”

Section: Introductionmentioning

confidence: 99%

“…5,6,7 Paracetamol being a non-opioid analgesics is devoid of the potential risks of opioids. 7 It has an established record of safety, efficacy and tolerance in adults. 8 It is the first line drug recommended by the World Health Organization (WHO) in analgesic ladder approach for pain management.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast to opioid, paracetamol does not produce sedation, respiratory depression, ileus and constipation, and is not associated with dependence or misuse. 1,6,7 Paracetamol is well tolerated drug but at times may cause nausea, vomiting, abdominal pain, diarrhea and rarely liver toxicity. 6,7 The drug interaction of the paracetamol is less and has very few contraindications.…”

Section: Introductionmentioning

confidence: 99%

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Postoperative Analgesia following Cesarean Section: Intravenous Paracetamol vs Pethidine

Shrestha

2018

Nep. Med. Coll. J.

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Effective analgesia is important after cesarean section. Intravenous paracetamol has been internationally accepted as a part of multimodal approach to pain management in post operative period. The purpose of the study was to compare the efficacy of intravenous paracetamol with pethidine in postoperative pain management in cesarean section. One hundred and eight patients undergoing cesarean section were studied over six months. The patients were divided into two equal groups. Group I received 900mg / 100 ml of intravenous paracetamol at the end of surgery and every 6 hrs for 24 hrs and group II received intramuscular 50 mg pethidine every 8 hours. Intramuscular Diclofenac sodium 75 mg was used as a rescue drug to both the groups. Visual analogue score was used to assess the pain level at 6, 12 and 24 hours postoperatively. The postoperative pain scores in both the groups were comparable. There was no significant difference in the consumption of additive analgesics. On the basis of current study we can reasonably recommend intravenous paracetamol in the postoperative pain management after cesarean section as it maintains a sustained and safe analgesic as it does not have side effects.

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Single dose intravenous paracetamol or intravenous propacetamol for postoperative pain

McNicol

Ferguson

Haroutounian

et al. 2016

Cochrane Database of Systematic Reviews

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Since the last version of this review, we have found 39 new studies providing additional information. Most included studies evaluated adults only. We reanalyzed the data but the results did not substantially alter any of our previously published conclusions. This review provides high quality evidence that a single dose of either IV paracetamol or IV propacetamol provides around four hours of effective analgesia for about 36% of patients with acute postoperative pain. Low to very low quality evidence demonstrates that both formulations are associated with few adverse events, although patients receiving IV propacetamol have a higher incidence of pain on infusion than both placebo and IV paracetamol.

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Preventive Analgesia with Intravenous Paracetamol for Post-cesarean section Pain Control

Cited by 8 publications

References 20 publications

Effect of Different Doses of Paracetamol on Postoperative Pain After Gynecologic Laparoscopy

Effect of Different Doses of Paracetamol on Postoperative Pain After Gynecologic Laparoscopy

Postoperative Analgesia following Cesarean Section: Intravenous Paracetamol vs Pethidine

Single dose intravenous paracetamol or intravenous propacetamol for postoperative pain

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