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Intravenous paracetamol as adjunctive treatment for postoperative pain after cardiac surgery: a double blind randomized controlled trial.
Eur J Cardiothorac Surg. 2007 Sep; 32(3):527-31.EJ

Abstract

BACKGROUND

Nonsteroidal anti-inflammatory drugs and opioids are routinely used after cardiac surgery in order to mitigate postoperative pain; however, these drugs are burdened by side effects. Tramadol and paracetamol are believed to be lacking in such side effects. The aim of this study was to examine the efficacy of intravenous paracetamol as an adjunctive analgesic to a tramadol-based background analgesia after cardiac surgery.

METHODS

A total of 113 patients participated in this single center, placebo-controlled, double-blind, randomized trial. Fifty-six patients were randomized to receive paracetamol and 57 to placebo. Intravenous study drug (1 g) was administered 15 min before the end of surgery and every 6h for 72 h. Standard analgesia (tramadol) and anti-emetic prophylactic regimen (ondansetron) were available to both patient groups. Postoperative pain was evaluated by visual analog scale, and it was measured at rest and during a deep breath. A rescue dose of 2-5 mg of intravenous morphine was administered whenever the VAS score was greater than 3.

RESULTS

Baseline characteristics were equivalent between the two groups. At 12, 18, 24 h after the end of operation, patients who received paracetamol had significantly less pain at rest (p=0.0041, 0.0039, 0.0044, respectively); after this time the two groups did not differ. During a deep breath the difference was significant only at 12 h (p=0.0040). Paracetamol group required less cumulative morphine than placebo group (48 mg vs 97 mg) even if the difference did not reach statistical significance (p=0.274).

CONCLUSIONS

In patients undergoing cardiac surgery, intravenous paracetamol in combination with tramadol provides effective pain control.

Authors+Show Affiliations

Department of Anesthesia and Intensive Care, Sant'Orsola-Malpighi Hospital, University of Bologna, Italy. iolter.cattabriga@fastwebnet.itNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

17643995

Citation

Cattabriga, Iolter, et al. "Intravenous Paracetamol as Adjunctive Treatment for Postoperative Pain After Cardiac Surgery: a Double Blind Randomized Controlled Trial." European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, vol. 32, no. 3, 2007, pp. 527-31.
Cattabriga I, Pacini D, Lamazza G, et al. Intravenous paracetamol as adjunctive treatment for postoperative pain after cardiac surgery: a double blind randomized controlled trial. Eur J Cardiothorac Surg. 2007;32(3):527-31.
Cattabriga, I., Pacini, D., Lamazza, G., Talarico, F., Di Bartolomeo, R., Grillone, G., & Bacchi-Reggiani, L. (2007). Intravenous paracetamol as adjunctive treatment for postoperative pain after cardiac surgery: a double blind randomized controlled trial. European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery, 32(3), 527-31.
Cattabriga I, et al. Intravenous Paracetamol as Adjunctive Treatment for Postoperative Pain After Cardiac Surgery: a Double Blind Randomized Controlled Trial. Eur J Cardiothorac Surg. 2007;32(3):527-31. PubMed PMID: 17643995.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Intravenous paracetamol as adjunctive treatment for postoperative pain after cardiac surgery: a double blind randomized controlled trial. AU - Cattabriga,Iolter, AU - Pacini,Davide, AU - Lamazza,Gaia, AU - Talarico,Francesco, AU - Di Bartolomeo,Roberto, AU - Grillone,Giovanni, AU - Bacchi-Reggiani,Letizia, Y1 - 2007/07/23/ PY - 2007/01/08/received PY - 2007/05/22/revised PY - 2007/05/23/accepted PY - 2007/7/24/pubmed PY - 2008/2/15/medline PY - 2007/7/24/entrez SP - 527 EP - 31 JF - European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery JO - Eur J Cardiothorac Surg VL - 32 IS - 3 N2 - BACKGROUND: Nonsteroidal anti-inflammatory drugs and opioids are routinely used after cardiac surgery in order to mitigate postoperative pain; however, these drugs are burdened by side effects. Tramadol and paracetamol are believed to be lacking in such side effects. The aim of this study was to examine the efficacy of intravenous paracetamol as an adjunctive analgesic to a tramadol-based background analgesia after cardiac surgery. METHODS: A total of 113 patients participated in this single center, placebo-controlled, double-blind, randomized trial. Fifty-six patients were randomized to receive paracetamol and 57 to placebo. Intravenous study drug (1 g) was administered 15 min before the end of surgery and every 6h for 72 h. Standard analgesia (tramadol) and anti-emetic prophylactic regimen (ondansetron) were available to both patient groups. Postoperative pain was evaluated by visual analog scale, and it was measured at rest and during a deep breath. A rescue dose of 2-5 mg of intravenous morphine was administered whenever the VAS score was greater than 3. RESULTS: Baseline characteristics were equivalent between the two groups. At 12, 18, 24 h after the end of operation, patients who received paracetamol had significantly less pain at rest (p=0.0041, 0.0039, 0.0044, respectively); after this time the two groups did not differ. During a deep breath the difference was significant only at 12 h (p=0.0040). Paracetamol group required less cumulative morphine than placebo group (48 mg vs 97 mg) even if the difference did not reach statistical significance (p=0.274). CONCLUSIONS: In patients undergoing cardiac surgery, intravenous paracetamol in combination with tramadol provides effective pain control. SN - 1010-7940 UR - https://www.unboundmedicine.com/medline/citation/17643995/Intravenous_paracetamol_as_adjunctive_treatment_for_postoperative_pain_after_cardiac_surgery:_a_double_blind_randomized_controlled_trial_ L2 - https://academic.oup.com/ejcts/article-lookup/doi/10.1016/j.ejcts.2007.05.017 DB - PRIME DP - Unbound Medicine ER -