Reduced anaesthetic requirements and postoperative analgesics in patients undergoing laparoscopic cholecystectomy: Premedication with intravenous paracetamol versus ketorolac, a double blind and randomised clinical trial
文摘
To compare the effects of premedication with intravenous paracetamol versus ketorolac, in decreasing intraoperative anaesthetic and postoperative opioid analgesics requirements in patients undergoing laparoscopic cholecystectomy.MethodAn experimental, prospective, comparative, double blind, and randomised clinical trial was conducted to determine intraoperative opioid requirements, and pain and analgesic requirements in the postoperative period in 100 healthy patients undergoing laparoscopic cholecystectomy. They were randomised into 2 groups: Group 1: pre-medicated with paracetamol 1 g, and Group 2: with ketorolac 30 mg (both administered intravenously 30 min prior to surgery).ResultsThere were no statistically significant differences between groups as regards intraoperative remifentanil use (Group 1: 0.0739 ± 0.016 μg/kg/min, Group 2: 0.0741 ± 0.018 μg/kg/min). The number of patients in Group 2 that had values of VAS > 4 points (22.4%) was lower than in Group 1 (28.6%), but with no statistically significant difference. Of the patients who needed postoperative opioid rescue, most required a single rescue and application of analgesics during hospitalisation that prevailed between 3 and 12 h, without any significant differences between groups. No adverse effects were observed in the study sample.ConclusionParacetamol 1 g IV given preoperatively decreased anaesthetic requirements and the need for postoperative analgesics similar to the preoperative administration of ketorolac 30 mg IV.