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

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 100 mL normal saline, infused over 15 minutes in the end of surgery. Abdominal and shoulder pain scores were recorded in post-anesthesia care unit (PACU), 1, 2, 3, 6, 12, and 24 hours after the operation. The time of first request for analgesic and the values of liver enzymes were recorded. Results: During 24 hours after surgery, the prevalence of postoperative abdominal pain was 52.17% and 89.13% (P <0.001) and shoulder pain was 6.52% and 23.91% (P= 0.039) in the study and control groups, respectively. Abdominal pain score (0.06 +/- 0.32 vs. 1.6 +/- 2.0; P < 0.001) and shoulder pain score (0.0 +/- 0.0 vs. 0.50 +/- 1.37; P=0.017) in PACU were lower in the study group compared to the control group. The time to first request for analgesic was significantly longer in the study group than that in the control group (P = 0.030). There was no significant difference in liver enzyme values in postoperative 24 hours between the groups (P> 0.05). Conclusions: Administration of both doses of paracetamol at the end of surgery was effective on postoperative pain; however, the best pain relief was obtained by paracetamol 2 g with no side effects.