Study of the Effects of Intravenous Paracetamol with Different Doses on Opioid Sparing during and after Upper Limb Surgeries

The use of opioids to control pain during and after surgeries is a current method in anesthesia, but the side effects of these drugs like nausea, vomiting and respiratory depression have made us decrease their use. One proposal is to use NSAIDs in order to decrease the doses of opioid drugs. One of these drugs is paracetamol which can be used intravenously. In this study we administered two different doses of intravenous paracetamol to help control pain in patients who had upper limb surgeries. The aim of the present study is to investigate whether intravenous paracetamol has a role in decreasing the use of opioids for pain control during and after surgeries. And if the answer is positive, what dose might be effective. Patients and This is a double-blind study which was carried out on 60 ASA(American Society of Anesthesiology) class I patients between the ages of 20 and 40. The subjects were divided into 3 groups, each of which included 20 patients. Group A received 15mg/kg and group B received 30mg/kg intravenous paracetamol before the induction of anesthesia. Group C was the control group. The method of induction and maintenance of anesthesia and pain control during and after surgery was the same in the three groups. The amount of recommended opioids in the three groups was measured and recorded according to a similar protocol. The obtained results were assessed by Chi-square, ANOVA and Scheffe tests. With regard to the amount of administered fentanyl at the time of surgery, the difference between groups A and C and groups A and B was not significant, but the difference between groups B and C was significant(P=0.01). With regard to the amount of administered pethedin for pain control 6 hours after surgery, the difference between groups A and C and groups A and B was not significant, but the difference between groups B and C was significant(P=0.01). It is recommended that 30mg/kg intravenous paracetamol be administered before the induction of anesthesia to decrease the doses of opioids for pain control during and until 6 hours after upper limb surgeries.