DOI: http://dx.doi.org/10.18203/2320-1770.ijrcog20193798

A study of comparison of efficacy and side effects of intravenous paracetamol and intravenous diclofenac as a postoperative analgesic

Sharda A. Agrawal, Surendra D. Nikhate, Manasi M. Thakur, Himadri Bal

Abstract


B

Background: A postoperative patient suffers from pain the best relief of which is a clinician’s duty. Till date very few studies have been conducted for comparison of paracetamol and diclofenac as analgesics. As a result a comparative study between Paracetamol and Diclofenac was carried out. The aim of the study was to compare the efficacy and side effects of intravenous Paracetamol and intravenous Diclofenac in patients undergoing major abdominal open surgeries in obstetrics and gynaecology. The study was conducted to assess the postoperative visual analogue pain scores (VAS) and total analgesic requirement in the first 24 hours and also to study the total requirement of additional analgesics despite administration of either Paracetamol or Diclofenac in postoperative period.

Methods: 100 patients satisfying the inclusion/exclusion criteria were recruited for the study. They were divided into two groups of 50 each. Group A was given IV Paracetamol 6 hourly for 48 hours starting 2 hours after surgery. Group B was given IV Diclofenac 8 hourly for 48 hours starting 2 hours after surgery. Patients were assessed for pain relief by visual analogue scale (VAS) of zero to ten after 6 hours, 12 hours, 24 hours and 48 hours of surgery by asking the patient to point the position on the 100 mm scale.

Results: The results revealed that when we compared the VAS scores between the 2 Groups at different time intervals, it showed that at 24 hours and 48 hours VAS score in the Diclofenac Group was significantly less than the Paracetamol Group. The main side effects were nausea and vomiting in both the groups. There was more nausea and vomiting in Diclofenac group compared to Paracetamol group.

Conclusions: It was concluded that at 24 hour and 48 hour pain reduction was more in the Diclofenac group as compared to Paracetamol group, but the side effects were more in the Diclofenac group compared to Paracetamol group.


Keywords


Diclofenac, Paracetamol, Postoperative pain, VAS score

Full Text:

PDF

References


Merskey NB, Bogduk. N. Classification of chronic pain, international association for the study of pain task force on taxonomy. 2nd ed. Seattle. IASP Press. 1994:209-214.

Ashburn MA, Caplan RA, Carr DB. Practice guidelines for acute pain management in the perioperative setting: an updated report by the American Society of Anesthesiologists Task Force on acute pain management. Anesthesiology. 2004;100(6):1573-81.

Gan TJ. Diclofenac: An update on its mechanism of action and safety profile. Curr Med Res Opin. 2010;26(7):1715-31.

Graham GG, Scott KF. Mechanism of action of paracetamol. Am J Ther. 2005;12(1):46-55.

Mcnicol ED, Tzortzopoulou A, Cepeda MS, Francia MB, Farhat T, Schumann R. Single-dose intravenous paracetamol or propacetamol for prevention or treatment of postoperative pain: A systematic review and meta-analysis. Br J Anaesth. 2011;106(6):764-75.

Rømsing J, Møiniche S, Dahl JB. Rectal and parenteral paracetamol, and paracetamol in combination with NSAIDs, for postoperative analgesia. Br J Anaesth. 2002;88(2):215-26.

Ong CK, Seymour RA. An evidence-based update of the use of analgesics in dentistry. Periodontol. 2008;46(1):143-64.

Ashima T, Vidhushi M, Kaur T. Comparative study on the effect of paracetamol, diclofenac and their combination in post operative pain relief of cesarean section. JK Science. 2015;17(1):30.

Paul D, Jacob M, Narayan S. Comparative evaluation of efficacy of intravenous paracetamol and intravenous diclofenac as post-operative analgesia in laparoscopic cholecystectomy. Int J Biomed Research. 2015;6(7):482-7.

Sarika, Wadhwa R. Research article a randomised double blind study comparing preemptive analgesic efficacy of oral acetaminophen, diclofenac and combination of acetaminophen and diclofenac in modified radical mastectomy surgery. Int J Recent Scientific Res. 2015;6(10):6702-6706.

Ayan M, Taş U, Söğüt E, Arıcı S, Karaman S, Esen M, Demirtürk F. Comparing efficiencies of diclofenac sodium and paracetamol in patients with primary dysmenorrhea pain by using Visual Analog Scale. Agri. 2013;25(2):78-82.

Pal A, Biswas J, Mukhopadhyay P, Sanyal P, Dasgupta S, Das S. Diclofenac is more effective for post-operative analgesia in patients undergoing lower abdominal gynaecological surgeries: A comparative study. Anesth Essays Res. 2014;8(2):192-6.

Kumari UR, Zutshi V, Patel M, Marwah S. Analgesic efficacy of intravenous paracetamol versus intravenous tramadol after caesarean section: a single blind randomized controlled study. Int J Repro Contracep Obst Gyn. 2016;5:4285-9.