COMPARISON OF PRE-EMPTIVE PARACETAMOL AND PARACETAMOL-DICLOFENACCOMBINATION FOR POSTOPERATIVE PAIN AFTER SURGERIES UNDER GENERAL ANESTHESIA - A SINGLE-BLINDED RANDOMIZED CONTROL STUDY

Background: Postoperative pain control is a critical component of patient care. Effective pain control can improve patient comfort and reduces the risk of complications. Multimodal analgesia is one of the approaches used for postoperative pain control. The idea of combining analgesics is to reduce the side effects of each drug yet effectively deal with postoperative pain. The present study aimed to compare the time for the first analgesia request and compare the total amount of analgesic consumption in the two groups in the postoperative period in the first 24 hrs. 

Methods: The present study was a single-blinded randomized control study, done in the Department of Anesthesiology, MRMC, and Basaveshwar Teaching and General Hospital, Kalaburgi, Karnataka State. Patients undergoing surgeries under General Anaesthesia with ASA I/II categories were randomly allocated to two groups. Group A n=25 patients with Tab. Paracetamol oral(2gm). Group B n=25 patients with Tab. Paracetamol oral(1gm). + Inj Diclofenac 75mg IM. Postoperative NRS and first demand for rescue analgesia and total consumption of analgesic in two groups were compared.

Results: The mean values of NRS scores were found to be lesser in group B as compared to group A indicating better pain control in group B as compared to group A. The time for 1^st analgesia request was seen in 60% of group A in 2^nd hour and 32% in 1^st hour. Time for 1^st analgesia request was seen in 60% of patients in group B in the 3^rd hour and 20% in the 2^nd hour. The overall consumption of analgesics at the end of 24 hours was greater in Group A as compared to Group B.

Conclusion: Pre-emptive analgesia with inj. diclofenac is more effective when compared to a tab. paracetamol group alone in post-operative analgesia following elective surgeries. It can further improve the quality of multimodal analgesia during the post-operative period and can reduce the hospital stay and financial burden on the patient. Both paracetamol and diclofenac drugs are safe to provide analgesia in the postoperative period without any major significant side effects.