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...