Mahajan Lakshmi, Mittal Vaishali, Gupta Ruchi, Chhabra Himani, Vidhan Jyoti, Kaur Ashreen
Department of Anaesthesia, SGRD Medical College, Amritsar, Punjab, India.
Anesth Essays Res. 2017 Jul-Sep;11(3):594-598. doi: 10.4103/0259-1162.206872.
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.
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.
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.
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.
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. value of less than 0.05 was considered significant and less than 0.001 as highly significant.
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.
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.
剖宫产术后有效的疼痛缓解治疗对于产妇的舒适度和早期活动至关重要。与阿片类药物相比，对乙酰氨基酚具有出色的安全性。
评估和评价口服、直肠和静脉输注对乙酰氨基酚在脊髓麻醉下接受剖宫产的女性术后镇痛中的效果。
我们对计划行下段剖宫产的ASA-I和II级产妇（18-35岁）进行了一项前瞻性随机对照研究。
她们被随机分为3组，每组50人。A组在转入手术室前20分钟口服650毫克对乙酰氨基酚片（1片），B组在脊髓麻醉后立即直肠给予35-45毫克/千克对乙酰氨基酚栓剂，C组在手术结束前20分钟静脉输注10-15毫克/千克对乙酰氨基酚，持续15分钟。镇痛持续时间作为主要结局进行评估，其他参数作为次要结局。
所有统计分析均使用SPSS统计软件包17.0版本进行。结果使用非参数数据的卡方检验和参数数据的方差分析进行分析。P值小于0.05被认为具有统计学意义，小于0.001被认为具有高度统计学意义。
与A组和C组相比，B组的镇痛持续时间显著更长。与A组和C组相比，B组补充抢救镇痛的需求也更低。三组均未观察到明显的血流动力学紊乱和不良反应。
与口服和静脉途径相比，直肠给予对乙酰氨基酚在更大程度上改善了术后镇痛的质量和持续时间，且无任何副作用。
