EFFICACY AND SAFETY OF ACETAMINOPHEN COMPARED TO TRAMADOL AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Abstract

Background: Laparoscopic cholecystectomy become widely popular because of its less postoperative pain produced compared to conventional cholecystectomy. The use of opioids postoperatively to reduce pain may be harmful and produce some adverse effects .Tramadol is a centrally acting opioid which is effective for postoperative analgesic pain but produce undesirable adverse effects the patients do not tolerate it so that intravenous acetaminophen could be helpful to optimize postoperative analgesia by reducing the requirement for opioids and their adverse effects.

Method: A prospective randomized clinical trial was carried out on 27 adults undergoing elective laparoscopic cholecystectomy were randomly assigned to two groups in this study (13patients) to receive intravenously 1000mg acetaminophen and (14 patients) to receive intramuscularly tramadol 100mg postoperatively; visual analog scale (VAS) was utilized to asses pain severity and efficacy of analgesic agents. Pain scores were assessed at 0,2,4,6,8,10 and 12h after surgery the incidence of adverse effects was also assessed.

Results: Over a period of 12hours, visual analog scale (VAS) scores were significantly lower in each group at each time interval compared to zero time; there is a non significant difference in pain score between the different groups; the incidence of adverse effects like nausea and vomiting was significant in tramadol group compared to acetaminophen group.

Conclusion: Postoperative intravenous acetaminophen infusion of 1000mg is useful for reducing pain scores after elective laparoscopic cholecystectomy; it is effective and safe analgesic with less adverse effects compared to tramadol.

 

 

Key words: laparoscopic cholecystectomy, Acetaminophen, Tramadol, Postoperative analgesia.