Comparison of analgesic efficacy of intravenous Paracetamol and intravenous dexketoprofen trometamol in multimodal analgesia after hysterectomy

Backround: We aimed to evaluate analgesic efficacy, opioid-sparing, and opioid elated adverse effects of intravenous paracetamol and intravenous dexketoprofen rometamol in combination with iv morphine after total abdominal hysterectomy. Sixty American Society of Anesthesiologist Physical tatus Classification I-II patients scheduled for total abdominal hysterectomy were nrolled to this double-blinded, randomized, placebo controlled, and prospective study. atients were divided into three groups as paracetamol, dexketoprofen trometamol, and lacebo (0.9% NaCl) due to their post-operative analgesic usage. Intravenous patient controlled analgesia morphine was used as a rescue analgesic in all roups. Pain scores,hemodynamic parameters,morphine consumption, patient atisfaction, and side-effects were evaluated. Visual Analog Scale (VAS) scores were not statistically significantly ifferent among the groups in all evaluation times, but decrease in VAS scores was tatistically significant after the evaluation at 12th h in all groups. Total morphine onsumption (morphine concentration = 0.2 mg/ml) in group paracetamol(72.3 ± 38.0 l) and dexketoprofen trometamol (69.3 ± 24.1 ml) was significantly lower than group lacebo (129.3 ± 22.6 ml) (P < 0.001). Global satisfaction scores of the patients in group placebo was significantly lower than group dexketoprofen trometamol after surgery and the increase in global satisfaction score was significant only in group placebo. Dexketoprofen trometamol and Paracetamol didn’t cause significant change on pain scores, but increased patients’ comfort. Although total morphine consumption was significantly decreased by both drugs, the incidence of nausea and vomiting were similar among the groups.According to results of the present study routine addition of dexketoprofen trometamol and paracetamol to patient controlled analgesia morphine after hysterectomies is not recommended.