Effect of Intravenous Paracetamol on Acute Post-operative Pain, Nausea, and Vomiting after Outpatient Diagnostic Laparoscopy for Infertility

Abstract

Background: Post-operative pain, nausea, and vomiting (PONV) are significant causes of morbidity among patients undergoing outpatient diagnostic laparoscopy. However, the optimal strategy for prevention of these side effects remains unclear. Many drugs and their combination have been used to attenuate these adverse responses. We conducted a study to evaluate the effect of intravenous (IV) paracetamol on attenuation of acute post-operative pain and opioid consumption and as a result PONV at the same time in infertile women undergoing diagnostic laparoscopy.
Methods: A total of 104 American Society of Anesthesiologists  Class I-II infertile women aged 18-40 years, who were scheduled for elective diagnostic laparoscopy under general anesthesia, were included and anesthetized with the same technique. The paracetamol group received IV infusion of 1000 mg paracetamol in 100 ml saline, and the placebo group received the same volume of saline after induction of anesthesia. Pain score at the end of surgery and 1 hour later, PONV and fentanyl consumption as rescue analgesic at the recovery room were all recorded and compared between the two groups.
Results: There were no significant differences between the two groups regarding demographic data. Mean pain score was 2.8 ± 2.7 in paracetamol group and 4.3 ± 3.5 in placebo group at the end of surgery (P = 0.016). Mean pain score was 3.7 ± 2.1 in paracetamol group and 4.6 ± 2.2 in placebo group 1 hour after surgery (P = 0.030). Nearly 36% of patients in placebo group and 14% in paracetamol group need additional fentanyl for pain relief after surgery (P = 0.008). Incidence of post-operative nausea was 16.3% and 14.5% in placebo and paracetamol groups, respectively, (P = 0.150). Incidence of post-operative vomiting was 6% and 0 in placebo and paracetamol groups, respectively, (P = 0.040).
Conclusions: IV paracetamol reduced post-operative pain and nausea in infertile women undergoing diagnostic laparoscopy for assisted reproductive techniques.