Study to Compare the Effect of Oral, Rectal, and Intravenous Infusion of Paracetamol for Postoperative Analgesia in Women Undergoing Cesarean Section Under Spinal Anesthesia

Lakshmi Mahajan, Vaishali Mittal, Ruchi Gupta, Himani Chhabra, Jyoti Vidhan, Ashreen Kaur, Lakshmi Mahajan, Vaishali Mittal, Ruchi Gupta, Himani Chhabra, Jyoti Vidhan, Ashreen Kaur

Abstract

Background: Effective pain relief therapy after caesarean section is essential for the parturient's comfort and early ambulation. Paracetamol has an excellent safety profile when compared to opioids.

Aim: To assess and evaluate the effect of oral, rectal, and intravenous infusion of paracetamol for post-operative analgesia in women undergoing caesarean section under spinal anaesthesia.

Settings and design: We conducted a prospective, randomized controlled study (18-35 years of age) of the ASA- I and II parturient scheduled for lower segment caesarean section were included.

Methods and materials: They were randomly allocated to 3 groups of 50 each. Group A received oral paracetamol tablet 650mg (1 tablet) 20min before shifting to operation room, group B received rectal paracetamol suppository 35-45 mg/kg immediately after spinal anaesthesia and group C received i.v. paracetamol infusion of 10-15mg/kg over 15min duration 20min before finishing the operation. Duration of analgesia was evaluated as primary outcome and other parameters as secondary outcome.

Statistical tests: All statistical analyses were performed using the SPSS statistical package 17.0 version. Results were analyzed using Chi Square test for non-parametric data and ANOVA for parametric data. P value of less than 0.05 was considered significant and less than 0.001 as highly significant.

Results: Duration of analgesia was significantly longer in group B as compared to group A and C. The requirement of supplemental rescue analgesia was also lower in group B compared to group A and C. No significant haemodynamic derangements and adverse effects were noted among all the three groups.

Conclusion: Paracetamol when given rectally improves the quality and duration of postoperative analgesia to a greater extent as compared to oral and intravenous route of paracetamol without any side effects.

Keywords: Cesarean section; paracetamol; postoperative pain.

Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Consort diagram
Figure 2
Figure 2
Visual analog scale scoring in three groups postoperatively
Figure 3
Figure 3
Kaplan–Meyer analysis

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Source: PubMed

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