European Journal of Molecular & Clinical Medicine

Abstract

Background: Laparoscopic cholecystectomy is the preferred surgical technique for uncomplicated cholecystectomy. Recommended approach for post operative pain management is to initiate the treatment with analgesics such as paracetamol, NSAIDS followed by adjunctive use of opioids to treat more acute pain symptoms. Present study was aimed to compare intravenous paracetamol versus intravenous diclofenac for postoperative pain relief in elective laparoscopic cholecystectomy.
Material and Methods: Present study was prospective double blinded Randomised controlled study, conducted patients between 18 - 65 years, ASA physical status I/II, posted for laparoscopic cholecystectomy. 80 cases were randomly divided as Group A (75 mg Diclofenac: 40 cases) & Group B (1 gm Paracetamol: 40 cases).
Results: In present study difference in VAS score in group A & group B at all points was statistically not significant except at 6 Hours where difference in VAS score in both group was statistically significant (P value 0.02). After comparing the Visual Rating Scale (VRS) scores of both groups to assess postoperative pain, it was found that VRS score in group A was higher than group B at 15 minutes, 30 minutes & 6 hours and was statistically significant. It was found that 26 (65%) of patients in group A required rescue analgesic whereas 18(45%) in group B required rescue analgesic. However, the difference observed was statistically not significant (P= 0.072). It was found that 3 (7.5%) of patients in group B experienced an adverse effect whereas 6 (15%) in group A had an adverse effect. The difference was statistically not significant. (P=0.061).
Conclusion: Paracetamol is considered superior to diclofenac in laparoscopic cholecystectomy as paracetamol gives better & prolonged analgesia than Diclofenac as evidenced low VAS & VRS score and also lesser requirement of rescue analgesia.