1Department of Anesthesiology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
2Department of Anesthesiology, Faculty of Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
3Department of Obstetrics and Gynecology, Kaohsiung Municipal Siaogang Hospital, Kaohsiung, Taiwan
4Department of Anesthesiology, Kaohsiung Municipal Ta-Tung Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Outline
Background
Multimodal analgesia for acute pain provides better analgesia and fewer adverse effects of opioids. Propacetamol is a pro-drug of paracetamol that is the most widely used drug for acute pain. The study aimed to investigate the adjuvant analgesic effect of propacetamol in post-cesarean section pain relief within 48 hours.
Methods
We performed a prospective, randomized, placebo-controlled trial for single-dose intravenous propacetamol as an adjuvant to patient-controlled epidural analgesia (PCEA) after cesarean period. The parturients were allocated to additional propacetamol (Group P) or saline (Group C) injection immediately after the delivery of the placenta. Primary outcome was assessed by pain intensity at rest or during movement. We recorded postoperative pain scores by using the numeric rating scale (NRS 0-10) at postoperative care unit (PACU), 2, 6, 24 and 48 hours postoperatively. In addition, the total dosage of PCEA, rescue analgesic, motor block, adverse effects and maternal satisfaction were also recorded.
Results
A total of 60 obstetric patients agreed to participate and 59 completed the study (n=30 in Group P and n=29 in Group C). Pain intensity at rest in Group P was significantly lower compared to Group C within the initial 2 hours(p=0.04). Overall dosage consumption of PCEA and patient-requested rescue analgesic did not differ significantly between the two groups (p>0.05). There was also no obvious difference between groups with respect to muscle tone, adverse effects and satisfaction (P>0.05).
Conclusion
The combination of single-bolus intravenous 1 g propacetamol plus PCEA provided better pain relief at rest within 2 hours of administration.
Multimodal analgesia, post-cesarean analgesia, propacetamol, patientcontrolled epidural analgesia.
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