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A Comparative Study of Paracetamol and Tramadol in Hysterectomy Patients


Affiliations
1 Department of Obstetrics and Gynaecology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
2 Department of Obstetrics and Gynaecology, Pt. B. D. Sharma PGIMS, Rohtak - 124001, Haryana, India
3 Department of Obstetrics and Gynaecology, University College of Medical Sciences, New Delhi, India
     

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Aim: To compare the efficacy and side effects of paracetamol and tramadol infusion for postoperative analgesia after elective hysterectomy.

Materials and Methods: The present prospective study was conducted on 50 patients who underwent elective hysterectomy in a tertiary care hospital. The patients were divided into two groups. Group A received paracetamol (PCM) infusion, while group B received tramadol infusion. The analgesic efficacy of both the drugs was assessed by Visual Analogue Scale (VAS) at 15, 30 minutes, 1, 2, 4, 6 and 8 hours. The side effects were noted and compared. The records of all the parameters were maintained as per patient proforma.

Results: Both the groups were comparable with respect to demographic profile, duration and route of surgery. The pvalues for the VAS score at 15 min, 30 min, 1 hr, 6 hrs and 8 hrs were insignificant in both the groups. Although pain relief at two and four hours was better in patients of hysterectomy who received tramadol as compared to the patients who received paracetamol, additional analgesia was not required in most of the patients. The number of patients who experienced nauseavomiting (32%), sedation (20%) and headache (12%) were more in the tramadol group.

Conclusion: The present study demonstrates that PCM and tramadol has comparable analgesic effect. At the same time PCM has emerged as a safer analgesic in comparison to tramadol because of its fewer side effects.


Keywords

Paracetamol, Tramadol, Postoperative, Analgesia, Hysterectomy.
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  • Merskey H. Pain terms: a list with definitions and notes on usage. Recommended by the IASP subcommittee on Taxonomy. Pain 1979; 6:249-52.

  • Jorgen BD, Kehlet H. Postoperative pain and its management. In: McMohan SB, Koltzenburg M, eds. Wall and Melzack’s Textbook of pain. 5th ed. Elsevier Churchill Livingstone: Philadelphia; 2006.p.635-51.

  • Apfelbaum JL, Chen C, Mehta SS, Gan TJ. Postoperative pain experience: Results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg 2003; 97:534-40.

  • Duale C, Frey C, Bolangard F. Epidural versus intrathecal morphine for postoperative analgesia after caesarean section. Br J Anaesthesia 2003; 91:690-94.

  • Amjad A, Chohan U, Atif F. Intravenous tramadol vs ketorolac in laproscopic dye test. J Coll Phys Surg Pak 2005; 16:3-6.

  • Tarkkila P, Tuominen M, Lindgrel L. Comparision of respiratory effects of tramadol and pethidine. Eur J Anaesthesiol 1998;15:64-68

  • Moller PL, Juhl GD, Payen-Champenois C. Intravenous acetaminophen (Paracetamol): Comparable analgesic efficacy, but better local safety than its prodrug (propacetamol) for postoperative pain after third molar surgery. Anesth Analg 2005;101:90-96.

  • Landwehr S, Kiencke P, Giesecke T. A comparison between i.v. paracetamol and i.v. metamizol for postoperative analgesia after retinal surgery. Curr Med Res Opin 2005; 21:156975.

  • Palazon J, Tortosa JA, Martinez-Lage JF, Perez-Flores D. Intravenous administration of propacetamol reduces morphine consumption after spinal fusion surgery. Anesth Analg 2001; 92:1473-76.

  • Sinatra RS, Jahr JS. Efficiency and safety of single and repeated administration of 1 gram intravenous acetaminophen injection (paracetamol) for pain management after major orthopaedic surgery. Anesthesiol 2005; 102:822-31.

  • Binhas M, Decailliot F, Rezaiquia-Delclaux S, Suen P, Dumerat M, François V, et al. Comparative effect of intraoperative propacetamol versus placebo on morphine consumption after elective reduction mammoplasty under remifentanil-based anesthesia: a randomized control trial.BMC Anesthesiol 2004; 4:6-7.

  • Varrassi G, Marinangeli F, Agro F, Aloe L, De Cillis P, De Nicola A, et al. A double-blinded evaluation of propacetamol versus ketorolac in combination with patient-controlled analgesia morphine: Analgesic efficiency and tolerability after gynecologic surgery. Anesth Analg 1999; 88:611-6.

  • Dejonckheere M, Desjeux L, Deneu S, Ewalenko P. The efficacy of tramadol and propacetamol for pain after thyroidectomy. Acta Anaesthesiol Belg 2001; 5:29-33.

  • Khan ZU, Iqbal J, Saleh H, Mohammad A, Deek EL. Intravenous paracetamol is effective as morphine in knee arthroscopic day surgery procedure. Pak J Med Sci 2007;23:851-53.

  • Uysal HY, Takmaz SA, Yaman F, Baltaci B, Basar H. The efficacy of i.v paracetamol versus tramadol for postoperative analgesia after adenotonsillectomy in children. J Clin Anaesth 2011; 23:53-7.

  • Hoogewijs J, Diltoer MW, Hubloue I, Spapen HD. A prospective randomized, open-lable, single blind study comparing four analgesics in the treatment of peripheral injury in the emergency department. Eur J Emerg Med 2000;7:119-23.

  • Hadi MA, KamaruIjan HS, Saedah A, Abdullah NM. A comparative study of intravenous patient-controlled analgesia morphine and tramadol in patients undergoing major operation. Med J Malaysia 2006; Dec 61:570-76.

  • Cattabriga I, Paccini D, Lamazza G, Talarico F, Di Bartolomeo R, Grillone G, et al. Intravenous paracetamol as adjunctive treatment for postoperative pain after cardiac surgery: a double blind randomized controlled trial. Eur J Cardiothorac Surg 2007; 32:527-31.

  • Inal MT, Celik NS, Tunkay FS. Intravenous paracetamol is better than i.v meperidine infusion for postoperative analgesia after caesarean section. Int J Anaesthesiol 2007;15:67.

  • Kumari UR, Zutshi V, Patel M, Marwah S. Analgesic efficacy of intravenous paracetamol versus intravenous tramadol after caesarean section : a single blinded randomized controlled study. Int J Reprod Contracept Obstet Gynecol 2016;5:4285-9.

  • Aghamir K, Mojtahedzahed M, Alizahed F, Khalili Pharm H, Sadeghi M, Najafi A, et al. Propacetamol vs tramadol for postoperative pain management after urologic surgery. Int J Pharmacol 2006; 4:12-25.

  • Ranucci M, Cazaniga A, Soro G, Isgor G. Post-operative analgesia for early extubation after cardiac surgery: a prospective randomized trial. Minerva Anesthesiol 1999; 65: 859-65.

  • Agrawal JK, Pradhan W. Tramadol in Patient Controlled Analgesia for Postoperative Management. Postgrad Med J NAMS 2009;2:43-4.

  • Shahid M, Manjula BP, Sunil BV. A comparative study of intravenous paracetamol and intravenous tramadol for postoperative analgesia in laprotomies. Anesth Essays Res 2015;9:314-9.

  • Agrawal A, Panditrao MM, Joshi S. To compare intravenous paracetamol with tramadol given pre–emptively for intraoperative and postoperative analgesia- A randomized controlled train. Indian J Clin Anaesth 2018;5:9-12


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  • A Comparative Study of Paracetamol and Tramadol in Hysterectomy Patients

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Authors

Meenakshi Chauhan
Department of Obstetrics and Gynaecology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
Parul Bhugra
Department of Obstetrics and Gynaecology, Pt. B. D. Sharma PGIMS, Rohtak - 124001, Haryana, India
Upasana Verma
Department of Obstetrics and Gynaecology, University College of Medical Sciences, New Delhi, India
Astha Chauhan
Department of Obstetrics and Gynaecology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India
Smiti Nanda
Department of Obstetrics and Gynaecology, Pt. B. D. Sharma PGIMS, Rohtak, Haryana, India

Abstract


Aim: To compare the efficacy and side effects of paracetamol and tramadol infusion for postoperative analgesia after elective hysterectomy.

Materials and Methods: The present prospective study was conducted on 50 patients who underwent elective hysterectomy in a tertiary care hospital. The patients were divided into two groups. Group A received paracetamol (PCM) infusion, while group B received tramadol infusion. The analgesic efficacy of both the drugs was assessed by Visual Analogue Scale (VAS) at 15, 30 minutes, 1, 2, 4, 6 and 8 hours. The side effects were noted and compared. The records of all the parameters were maintained as per patient proforma.

Results: Both the groups were comparable with respect to demographic profile, duration and route of surgery. The pvalues for the VAS score at 15 min, 30 min, 1 hr, 6 hrs and 8 hrs were insignificant in both the groups. Although pain relief at two and four hours was better in patients of hysterectomy who received tramadol as compared to the patients who received paracetamol, additional analgesia was not required in most of the patients. The number of patients who experienced nauseavomiting (32%), sedation (20%) and headache (12%) were more in the tramadol group.

Conclusion: The present study demonstrates that PCM and tramadol has comparable analgesic effect. At the same time PCM has emerged as a safer analgesic in comparison to tramadol because of its fewer side effects.


Keywords


Paracetamol, Tramadol, Postoperative, Analgesia, Hysterectomy.

References