Comparative Study of Efficacy of IV Paracetamol vs IV Tramadol for Postoperative Pain Relief After Cardiac Surgery

Introduction: NSAIDs and opioids are routinely used after cardiac surgery to mitigate postoperative pain. The aim of this study was to study efficacy of IV paracetamol vs. IV tramadol for postoperative pain relief, effects on haemodynamic stability, and adverse side effects. Methods: After getting permission from ethics committee, all patients were divided into 2 groups of 30 each. One group received inj paracetamol (20 mg/kg) and other group received inj. tramadol (2 mg/kg). All patients received first dose of study drug at the end of surgery during skin suturing and doses were repeated at 8 hourly interval till 48 hours postoperatively. Haemodynamic parameters and pain score using VAS scale was evaluated at 8 hourly interval on day 1 and 2. Any rescue analgesia required and side effects of drug was noted. Result: It was found that IV paracetamol and tramadol provide good analgesic cover after cardiac surgery carried out with midline sternotomy without affecting cardio respiratory function. Manish Kela, Sanjeeta Umbarkar, Manjula Sarkar, Madhu Garasia, Introduction fter cardiac surgery patients Aexperience incisional pain associated with sternotomy, chest tube insertion, and 1,2 leg vein incision. Post operative pain is associated with adverse effects like myocardial ischaemia, respiratory insufficiency and thromboembolic 4,5 complications. Opioids and NSAIDs are administered parenterally to alleviate such pain. Efficacy of such drugs is limited by side effects like respiratory depression, 1,2,3 sedation, biliary spasm and (PONV). Therefore we need a drug which is not associated with these side effects. Department of Anaesthesia. Seth GS Medical College and KEM Hospital, Mumbai-400012. Aims and Objective To 1. Study efficacy of IV paracetamol vs. IV tramadol for postoperative pain relief 2. Effects on haemodynamic stability 3. Adverse side effects Study design It is a prospective randomised control study. After getting permission from ethics committee, all patients were divided into 2 groups of 30 patients each. One group received inj Paracetamol (20 mg/kg) and other group received inj. Tramadol (2 mg/kg). All patients in the 2 groups received first dose of study at the end of surgery during skin suturing and doses were repeated at 8 hourly intervals till 48 Bombay Hospital Journal, Vol. 53, No. 3, 2011 582 hours postoperatively. Postoperatively haemodynamic parameters and pain score using VAS scale was evaluated at 8 hourly interval on day 1 and 2. Any rescue analgesia required and side effects of drug was noted. Inclusion Criteria Al l pat ients undergo ing non emergency cardiac surgery carried out with standard midline sternotomy. Exclusion Criteria 1. Age <18 years and > 80 years 2. LVEF < 30%, 3. Sr. Creatinine > 2 mg% 4. Sr. Bilirubin > 2 mg%, 5. Coagulopathy, 6. Recent myocardial infarction, 7. Uncontrolled diabetes, 8. Recent stroke/TIA within 6 months Observation and Results Parameters between the two groups were compared using Student 't' test and Chi Square Test and p value < 0.05 is considered to be significant.