EFFICACY OF PREEMPTIVE AND PREVENTIVE ANALGESIA IN REDUCING POSTOPERATIVE RESCUE ANALGESIC REQUIREMENTS IN SURGICAL PATIENTS
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Keywords
Preemptive analgesia, Postoperative pain, Rescue analgesic, Haemodynamic.
Abstract
Background: To compare the efficacy of pre-emptive and preventive analgesia on postoperative requirement of rescue analgesic in surgical patients within 24 hours; along with haemodynamic changes.
Design: Prospective randomized study.
Materials and method: This study involved total of 90 patients, of either gender, aged between 18-65 years, belonging to American Society of Anesthesiology [ASA] grade I and II, who underwent surgery under general anaesthesia lasting up to 2 hours .They were randomly assigned into three groups: GROUP I-Preemptive group received1gm of IV Paracetamol(100ml) prior to skin incision and IV normal saline [NS](100 ml) prior to end of surgery; GROUP II- preventive group received IV NS(100 ml) and 1gm of IV Paracetamol(100ml) before skin incision and closure respectively ; GROUP-ⅠⅠⅠ control group received 100 ml of intravenous (IV) NS before skin incision and before closure.
Results: Pain scores between both Preemptive and Preventive groups observed to be non significant up to 24 hours. Between Group I vs Group III mean pain scores was observed to be higher in Control group and found to be statistically significant (P˂0.05)up to 12 hours, whereas at 24 hours it was statistically non-significant. In comparison between the Group II vs Group III mean pain scores were statistically significant until 8 hours, whereas at 12 hours and 24 hours were found to be non-significant.
Conclusion: Surgical patients undergoing surgery under general anaesthesia preemptive analgesia may provide adequate analgesia and stable hemodynamics perioperatively and decrease postoperative analgesic consumption whereas preventive analgesia provides relief in postoperative period.
References
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Dr. Amit Kumar
Assistant Professor Guru Teg Bahadur Hospital And University College of Medical Sciences Delhi
Dr. Mohd Shakir Naeem
Assistant Professor Department Of Anaesthesia Guru Teg Bahadur Hospital And University College Of Medical Sciences, Delhi-110095
Dr Sandhya B K
Senior Resident, Ramaiah Medical College And Hospital, Bangalore, Karnataka
Dr. Jitendra Singh
Department Anesthesia, Senior Specialist, Email - Jit.Drjit@Gmail.Com, UCMS, Guru Teg Bahadur Hospital, Dilshad Garden, New Delhi.