Comparison of Intravenous Dexmedetomidine and Paracetamol for Postoperative Analgesia in Abdominal Hysterectomy under General Anaesthesia

Dr. Megha Kundu; Dr Fareed Ahmed; Dr Pratibha Rathore; Dr Monika Rathore

Volume : IX, Issue : VIII, August - 2020

Comparison of Intravenous Dexmedetomidine and Paracetamol for Postoperative Analgesia in Abdominal Hysterectomy under General Anaesthesia

Dr. Megha Kundu, Dr Fareed Ahmed, Dr Pratibha Rathore, Dr Monika Rathore

Abstract :

Background: Hysterectomy is associated with moderate to severe postoperative pain. Adequate perioperative analgesia may lead to better postoperative pain management. Different pharmacological agents such as NSAID, paracetamol, α2 adrenoreceptor agonist etc have been used to provide postoperative analgesia. Methods: A randomised double blind interventional study was done on 100 ASA I/II patients between 20 and 60 years of age,undergoing elective abdominal hysterectomy under general anaesthesia and randomly divided into two groups. ASA III/IV patients, patients with H/O chronic illnesses, patients on previous opioid or α2 agonist treatment, and patients with coagulopathies or with difficult airway were excluded. Group A received IV dexmedetomidine in a dose of 1 μg/kg as a loading dose over 15 min prior to skin closure followed by 0.5 μg/kg per hour. Group B received IV paracetamol 15 mg/kg over 15 min just prior to skin closure and repeated after 6 hours. The patients were monitored for VAS score and hemodynamic parameters after extubation till 24hours. The rescue analgesics requirements were met with inj. tramadol (100 mg)IV when VAS score was recorded ≥ 3 and the time interval till requirement of first dose of rescue analgesia was recorded. Results: In Group A 48% required rescue analgesia as compared to 20% in Group B. Mean time (hrs) to first analgesia request was longer in Group B as compared to Group A (3.32 � 4.96 for A vs 6.42 � 9.54 for B ; P=0.01). Total postoperative tramadol consumption was also significantly lower in Group B as compared to Group A ( 0.9�1.38 for A vs 0.46�0.705 for B ; P=0.04). There was no significant difference in side effects between the two groups at different time intervals (p value>0.05). Conclusion: We conclude that paracetamol is associated with superior level of post operative analgesia as compared to Dexmedetomidine in surgical procedures of short duration and should form a part of multimodal analgesia.