J Korean Pain Soc.  1997 Nov;10(2):170-178.

The Effect of Postoperative Propacetamol on Acute Pain and Endocrine - Metabolic Response in Gynecological Surgery

• Han TH
• Seo JW
• Shin BH
• Son JC

Abstract

BACKGROUND
The analgesic efficacy and safety of propacetamol, an injectable prodrug of acetoam- inophen, in combination with intravenous morphine PCA were studied in 40 patients after gynecological surgery requiring lower abdominal incision.
METHODS
Using a double-blind, randomized, parallel-group design, the effects of four (every 6 hr) intravenous injections of 2 g propacelamol ( 1 g acetoaminophen) were compared with four injections of placebo (PL) immediately after surgery. Efficacy of cumulative dose of morphine and number of boluses requested was assessed over 24 hours by automated recording on the PCA device. It was assessed on pain scores rated on a ten-point verbal scale along with vital signs, K', glucose, BUN, creatinine, FI' and PIT were measured along with stress hormones (epinephrine, norepinephrine and cortisol).
RESULTS
There were no differences in demographic data between two groups. Propacetamol group demonstrated approximately 21% morphine sparing effect compared to placebo group (33.1 +/- 10.4 mg vs 41.4 +/- 8.0 mg). No significant differences noted in K, glucose, BUN, Creatinine, FT and PTT levels. There were significant increases in norepinephrine and cortisol in placebo group postoperatively, compared to preoperative values. At the same time, propacetamol group also showed significant changes in these hormones. Both group revealed high degree of patient satisfaction.
CONCLUSION
Propacetamol showed significant morphine sparing effect to some degree. Side effects were much less in propacetamol group with subsequently high patient satisfaction. The secretion of stress hormone were not blocked by postoperative propacetamol injections. Authors concluded that propacetamol should be considered as an excellent adjuvant analgesics in postoperative pain control in opioid patient controlled analgesia.

Keyword

Analgesia, patient-controlled, mephme; Acute pain managernent, propacetamol; Morphine- sparing effect

MeSH Terms

Acute Pain*
Analgesia, Patient-Controlled
Analgesics
Creatinine
Female
Glucose
Gynecologic Surgical Procedures*
Humans
Hydrocortisone
Injections, Intravenous
Morphine
Norepinephrine
Pain, Postoperative
Passive Cutaneous Anaphylaxis
Patient Satisfaction
Vital Signs
Analgesics
Creatinine
Glucose
Hydrocortisone
Morphine
Norepinephrine