Intravenous paracetamol infusion: Superior pain management and earlier discharge from hospital in patients undergoing palliative head-neck cancer surgery

• Published in: Perspectives in clinical research 2014-10, Vol.5 (4), p.172-177
• Main Authors: Majumdar, Saikat, Das, Anjan, Kundu, Ratul, Mukherjee, Dipankar, Hazra, Bimal, Mitra, Tapobrata
• Format: Article
• Language: English
• Subjects: Acetaminophen; Admission and discharge; Care and treatment; Dosage and administration; Head and neck cancer; Hospitals; Intravenous paracetamol; Management; Original; Pain; postoperative analgesia; Postoperative care; Surgery; surgical intensive care unit
• ISSN: 2229-3485; 2229-5488
• DOI: 10.4103/2229-3485.140557

Paracetamol; a cyclooxygenase inhibitor; acts through the central nervous system as well as serotoninergic system as a nonopioid analgesic. A prospective, double-blinded, and randomized-controlled study was carried out to compare the efficacy of preoperative 1g intravenous (iv) paracetamol with placebo in providing postoperative analgesia in head-neck cancer surgery. From 2008 February to 2009 December, 80 patients for palliative head-neck cancer surgery were randomly divided into (F) and (P) Group receiving ivplacebo and iv paracetamol, respectively, 5 min before induction. Everybody received fentanyl before induction and IM diclofenac for pain relief at8 hourly for 24 h after surgery. Visual analogue scale (VAS) and amount of fentanyl were measured for postoperative pain assessment (24 h). The mean VAS score in 1(st), 2(nd) postoperative hour, and fentanyl requirement was less and the need for rescue analgesic was delayed in ivparacetamol group which were all statistically significant. Paracetamol group had a shorter surgical intensive care unit (SICU) and hospital stay which was also statistically significant. The study demonstrates the effectiveness of ivparacetamol as preemptive analgesic in the postoperative pain control after head-neck cancer surgery and earlier discharge from hospital.