Comparative Efficacy of Pre-emptive Analgesic Effects of Intravenous Paracetamol and Intravenous Ketorolac in Patients Undergoing Laparoscopic Cholecystectomy

Abstract

Introduction: Accurate management of pain is one of the most important challenges of health care providers and one of the most important concerns of the patients in postoperative period. This study aims to compare the pre-emptive analgesic effects of intravenous paracetamol with intravenous ketorolac in patients undergoing laparoscopic cholecystectomy under general anesthesia.

Methods: This study was conducted atWestern Regional Hospital, Pokhara Academy of Health Sciences and adult patients undergoing laparoscopic cholecystectomy under general anesthesia were included in our study. Seventy patients were divided into two groups of 35 each:group P – Paracetamol group, where patients receivedintravenous paracetamol andgroup K – where patients received intravenous ketorolac as pre-emptive analgesia 30 minutes before induction of anesthesia. The incidence of pain in post-operative period was assessed using Numerical Rating Scale (NRS).

Results: There was no significant difference in demographic and hemodynamic variables,the incidence of mild pain was greater and moderate pain was lesser in post-operative period in group paracetamol than group ketorolac but these differences were statistically not significant except at 30 minutes after surgery (p=0.04).NRS score of pain was significantly lower in paracetamol group {median (interquartile range) – 2(1,3)} than in ketorolac group {3(2,3), p=0.006}. The consumption of pethidine in post-operative period between the two groups was comparable (p=0.269)

Conclusion: Pre-emptive analgesia with injection paracetamol provides better analgesia than injection ketorolac in first 24 hours of post-operative period in patients undergoing laparoscopic cholecystectomy but these were statistically not significant except at 30 minutes after the end of surgery.