Evaluation of the effect of preemptive intravenous paracetamol on perioperative pain in coronary artery bypass graft surgery

Abstract

Background: The most common method of pain control after coronary artery bypass graft surgery is utilization of opioids and non-steroidal anti-inflammatory drugs (NSAIDs). In this study, the authors investigated the analgesic effects of intravenous paracetamol, while aiming to minimalize systemic side effects. Methods: In this prospective, randomized and triple-blinded clinical trial, patients were studied in two groups: a control group (n = 42) and a group treated with paracetamol (n = 51). The paracetamol group received an intravenous injection of the drug 15 minutes before induction of anesthesia and then every 6 hours for 3 days, 1 g paracetamol in 50 ml normal saline was infused in 15 minute. In the control group, normal saline was used instead of paracetamol in all stages of study in the same volume. Findings: Reported pain severities during resting after 24 (P = 0.002) hour and deep breathing after 12 (P = 0.001), 24 (P < 0.001) and 72 (P = 0.031) hour were significantly lower in the paracetamol group. There was no significant difference between the two groups, in terms of the amount of opioid requirements during (P = 0.246) and after (P = 0.853) surgery. Conclusion: Preemptive and then continuous prescription and use of paracetamol after cardiac surgery improves the quality of postoperative pain control of opioids. However, the potency of paracetamol alone is not enough to reduce the required dose and the side effects of opioid and sedative drugs. � 2016, Isfahan University of Medical Sciences(IUMS). All rights reserved.