Analgesic Efficacy of Diclofenac and Paracetamol vs. Meperidine in Cesarean Section

Darvish, Heidar; Ardestani, Behrouz Memar; Shali, Sara Mohammadkhani; Tajik, Ali

doi:10.5812/aapm.9997

Cited by 11 publications

(11 citation statements)

References 21 publications

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“…spinal, epidural and caudal anesthesia as well as IVRA), which is a significant feature for meperidine among all opioids ( 13 - 15 ). However, following its widespread use, in recent years there were some concerns about its special hazards in systemic administration, which at least in part could enhance turning to intraarticular and other non-systemic routs of application ( 26 - 29 ). Compared with morphine, solubility of meperidine in fat tissue is higher, which advances its onset of action owing to its rapid absorption into blood circulation in the joint region with high flow of blood ( 30 ).…”

Section: Discussionmentioning

confidence: 99%

The Effect of Intra-Articular Meperidine and Bupivacaine 0.5% on Postoperative Pain of Arthroscopic Knee Surgery; a Randomized Double Blind Clinical Trial

Imani¹,

Entezary²,

Razi³

et al. 2015

Anesth Pain Med

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Background:Arthroscopic knee surgeries have a painful postoperative course, which often necessitates acute pain management. Among different analgesia techniques, Intra-articular injection is the technique of choice for many pain specialists, based on its confined effect to the surgical site (knee), lack of systemic effects and promotion of safe early ambulation.Objectives:The aim of this study was to compare analgesic effects of intra-articular meperidine, bupivacaine 0.5% or their combination after knee arthroscopic surgery.Patients and Methods:Sixty ASA class I-II patients’ candidates for arthroscopy knee surgery enrolled in a randomized double blind study to receive either 20 mL of bupivacaine 0.5%; 100 mg meperidine (diluted in normal saline) or bupivacaine 0.5% along with 100 mg meperidine. A written informed consent was obtained from all patients. Postoperative analgesia duration, VAS at 2, 6, 12 and 24 hours, the first analgesic request time, total fentanyl consumption in first 24 hours, patients’ satisfaction and adverse effects were recorded.Results:The bupivacaine-meperidine group had better duration of postoperative analgesia (P = 0.001), latter first analgesic request (P ≤ 0.001), lower total fentanyl consumption in first 24 hours after the operation (P = 0.001), less mean VAS at 2 hours (P = 0.001) and more patients’ overall satisfaction (P = 0.01) compared with each medication alone. VAS at 6, 12 and 24 postoperative hours were not different between the groups of study. No adverse effects were observed.Conclusions:Although postoperative intra-articular meperidine is a better alternative for bupivacaine, their combination could improve their analgesic effects compared with each other alone.

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Section: Discussionmentioning

confidence: 99%

The Effect of Intra-Articular Meperidine and Bupivacaine 0.5% on Postoperative Pain of Arthroscopic Knee Surgery; a Randomized Double Blind Clinical Trial

Imani¹,

Entezary²,

Razi³

et al. 2015

Anesth Pain Med

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“…There are some reports of its successful use to reduce postoperative pain following cesarean section by general anesthesia ( 14 - 17 ). However, there is only one report of its use for blunting circulatory response to endotracheal intubation for cesarean section ( 18 ).…”

Section: Introductionmentioning

confidence: 99%

Effect of Intravenous Acetaminophen (Paracetamol) on Hemodynamic Parameters Following Endotracheal Tube Intubation and Postoperative Pain in Caesarian Section Surgeries

2015

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Background:Use of analgesics, especially opioids, before delivery during cesarean section for preventing hemodynamic changes after endotracheal intubation and postoperative analgesia is limited due to their adverse effects on the neonate.Objectives:The aim of this study was to investigate the effect of intravenous acetaminophen (paracetamol) in blunting hemodynamic responses to endotracheal intubation and postoperative pain in parturient undergoing cesarean section by general anesthesia.Patients and Methods:Eighty parturients undergoing cesarean section by general anesthesia were randomly divided to receive either 15 mg/kg intravenous paracetamol (n = 40) or normal saline (n = 40) fifteen minutes before endotracheal intubation. Mean arterial blood pressure (MAP) and pulse rates were compared at baseline and after intubation at one minute interval for five minutes between the two groups. The patients were also compared for postoperative pain intensity and analgesic requirement.Results:Patients in the saline group experienced more pain in the recovery room (VAS 7.0 ± 1.24 vs. 6.15 ± 2.27; P value = 0.041) and required more fentanyl intraoperatively (150 µg vs. 87.7 ± 75; P value < 0.01) and meperidine postoperatively (12.88 ± 20.84 mg vs. 1.35 ± 5.73; P value = 0.002) than the paracetamol group. Mean arterial pressure (MAP) changes were similar after intubation in the both groups (P value = 0.71), however, pulse rates showed greater changes following intubation in the saline group (P value = 0.01).Conclusions:Intravenous acetaminophen administered before caesarean section reduced tachycardia after intubation, narcotic drugs administration during and after the operation and reduced pain in PACU.

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“…However, the analgesics, such as opioids and acetaminophen and NSAIDs have been previously used for postoperative pain management. Therefore, a combination therapy proves to be more effective than a single therapy (7). The medical routes of administration include oral, intravenous, intramuscular, subcutaneous, rectal, transdermal, intrathecal, and epidural analgesics (5,11).…”

Section: Resultsmentioning

confidence: 99%

“…Insufficient pain control can result in complications like delayed wound healing, infection, long period of hospitalization, and peripheral and central sensitization that can lead to persistent post-operative pain (3)(4)(5). So In all surgical procedures, the post-operative pain management is an important part of post-operative care (6,7). In recent years, significant progress has been made in understanding the pain process and the development of analgesic agents and the associated techniques.…”

Section: Introductionmentioning

confidence: 99%

Analgesic efficacy of morphine versus concurrent use of ketorolac and Acetaminophen in mandibular bone surgery

Mesgarzadeh¹,

Manshadi²,

Farnia³

2016

Int.J.Curr.Res.Aca.Rev.

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Background: Pain, a major issue in medical treatment, is one of the major concerns for both the clinician and the patient. Postoperative acute pain management during the initial hours is very important and can prevent side effects. Analgesics (acetaminophen, opioids) and nonsteroidal anti-inflammatory drugs are used as medications for pain control. Objective: This study was performed to compare the analgesic efficacy of morphine versus the concurrent use of ketorolac and intravenous acetaminophen after mandibular bone surgery. Materials and Methods: In this prospective, single-centered, randomized, double-blind clinical trial study, a total of 60 patients referred to Imam Reza Hospital in 2015 for mandibular bone surgery were randomized post-surgery into two groups: In group 1, acetaminophen (1 g in 100 cc normal saline solution) and ketorolac (30 mg in 100 cc normal saline solution) were infused every 6 hours. In group 2, morphine sulfate (0.1 mg/kg in 100 cc normal saline solution) was infused every 4 hours. The pain level was recorded on the visual analogue scale (VAS) at 1, 2, 4, 6, 12, and 24 hours after surgery. Results: Significant differences were found between the two groups in most hours. The mean pain level according to the VAS in group 1 and group 2 were 6.87±2.43 vs.7.20±2.06 (p = 0.560) for the 1 st hour post operation, 5.80±2.76 vs. 4.03±2.25 (p = 0.008) for the 2 nd hour post operation, 5.03±3.01 vs. 3.10±2.11 (p = 0.005) for the 4 th hour post operation, 3.37±3.03 vs. 1.77±1.92 (p = 0.017) for the 6 th hour post operation, 2.10±2.44 vs. 0.73±1.28 (p = 0.008) for the 12 th hour post operation and 1.30±1.91 vs. 0.60±1.28 (p = 0.101) for the 24 th hour post operation. No significant difference was observed in the 1 st and 24 th hour post-operation. Nausea was seen in the groups as one of the side effects with no significant difference. Conclusion: Morphine showed better efficiency in pain control than the concurrent use of ketorolac and intravenous acetaminophen.

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Analgesic Efficacy of Diclofenac and Paracetamol vs. Meperidine in Cesarean Section

Cited by 11 publications

References 21 publications

The Effect of Intra-Articular Meperidine and Bupivacaine 0.5% on Postoperative Pain of Arthroscopic Knee Surgery; a Randomized Double Blind Clinical Trial

The Effect of Intra-Articular Meperidine and Bupivacaine 0.5% on Postoperative Pain of Arthroscopic Knee Surgery; a Randomized Double Blind Clinical Trial

Effect of Intravenous Acetaminophen (Paracetamol) on Hemodynamic Parameters Following Endotracheal Tube Intubation and Postoperative Pain in Caesarian Section Surgeries

Analgesic efficacy of morphine versus concurrent use of ketorolac and Acetaminophen in mandibular bone surgery

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