Perioperative intravenous paracetamol as adjunctive treatment for postoperative pain relief after orthopaedic surgery involving lower limb bone fracture

Perioperative intravenous paracetamol as adjunctive treatment for postoperative pain relief after orthopaedic surgery involving lower limb bone fracture

Backgraound: Perioperative intravenous paracetamol has been shown to reduce postoperative pain scores and morphine consumption in certain surgical populations. We studied the effects of perioperative intravenous paracetamol on postoperative pain relief among patients undergoing orthopaedic surgery f...

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Main Author: Muda, Mohd Izwan Azmi
Format: Thesis
Language:English
Published: 2016
Subjects:
RD Surgery
Online Access:http://eprints.usm.my/43255/1/Dr.%20Mohd%20Izwan%20Azmi%20Muda-24%20pages.pdf
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spelling my-usm-ep.432552019-04-12T05:25:32Z Perioperative intravenous paracetamol as adjunctive treatment for postoperative pain relief after orthopaedic surgery involving lower limb bone fracture 2016 Muda, Mohd Izwan Azmi RD Surgery Backgraound: Perioperative intravenous paracetamol has been shown to reduce postoperative pain scores and morphine consumption in certain surgical populations. We studied the effects of perioperative intravenous paracetamol on postoperative pain relief among patients undergoing orthopaedic surgery for lower limb bone fractures. Our primary end points were a reduction in postoperative pain score and cumulative morphine consumption 6 hours postoperatively Methods: 62 patients undergoing orthopaedic surgery involving lower limb bone fractures that fulfilled inclusion and exclusion criteria were recruited in Hospital Universiti Sains Malaysia and randomized into two groups. The intravenous paracetamol group (n = 31) received intravenous paracetamol 1 gram (100 ml) at skin closure while the placebo group (n = 31) received intravenous normal saline (100 ml) at skin closure. Both groups received a standardized regimen of general anaesthesia and were given intravenous morphine postoperatively via a Patient Controlled Analgesia Device. Postoperative pain score, cumulative morphine consumption and side effects were recorded using a visual analogue scale at 30 minutes, 3 and 6 hours postoperatively. Results: The mean pain scores were significantly lower in intravenous paracetamol group compare to placebo group in resting (mean ± SD = 4.23 ± 1.63 VS 5.42 ± 2.41 at 30 min, p = 0.015; 2.81 ± 1.58 VS 4.19 ± 2.09 at 3 hours, p = 0.005; 2.23 ± 1.20 VS 3.23 ± 1.86 at 6 hours, p = 0.015) and moving (mean ± SD = 6.45 ± 1.69 VS 7.26 ± 2.21 at 30 min, p = 0.111; 5.00 ± 1.79 VS 6.48 ± 1.86 at 3 hours, p = 0.002; 4.35 ± 1.38 VS 5.35 ± 1.70 at 6 hours, p = 0.014). There were no significant different in cumulative morphine consumption between intravenous paracetamol and placebo group despite total cumulative morphine consumption for intravenous paracetamol group was lower than placebo group (mean ± SD = 14.65 ± 10.12 VS 20.61 ± 14.33, p = 0.063). Incidence of side effects was similar between the two groups. Conclusion: This study show beneficial effects of perioperative intravenous paracetamol as part of multimodal analgesia for patients who have lower limb bone fractures going for orthopaedic procedures. We recommended the use of intravenous paracetamol as part of multimodal analgesia in treating postoperative pain. 2016 Thesis http://eprints.usm.my/43255/ http://eprints.usm.my/43255/1/Dr.%20Mohd%20Izwan%20Azmi%20Muda-24%20pages.pdf application/pdf en public masters Universiti Sains Malaysia Pusat Pengajian Sains Perubatan
institution Universiti Sains Malaysia
collection USM Institutional Repository
language English
topic RD Surgery
spellingShingle RD Surgery
Muda, Mohd Izwan Azmi
Perioperative intravenous paracetamol as adjunctive treatment for postoperative pain relief after orthopaedic surgery involving lower limb bone fracture
description Backgraound: Perioperative intravenous paracetamol has been shown to reduce postoperative pain scores and morphine consumption in certain surgical populations. We studied the effects of perioperative intravenous paracetamol on postoperative pain relief among patients undergoing orthopaedic surgery for lower limb bone fractures. Our primary end points were a reduction in postoperative pain score and cumulative morphine consumption 6 hours postoperatively Methods: 62 patients undergoing orthopaedic surgery involving lower limb bone fractures that fulfilled inclusion and exclusion criteria were recruited in Hospital Universiti Sains Malaysia and randomized into two groups. The intravenous paracetamol group (n = 31) received intravenous paracetamol 1 gram (100 ml) at skin closure while the placebo group (n = 31) received intravenous normal saline (100 ml) at skin closure. Both groups received a standardized regimen of general anaesthesia and were given intravenous morphine postoperatively via a Patient Controlled Analgesia Device. Postoperative pain score, cumulative morphine consumption and side effects were recorded using a visual analogue scale at 30 minutes, 3 and 6 hours postoperatively. Results: The mean pain scores were significantly lower in intravenous paracetamol group compare to placebo group in resting (mean ± SD = 4.23 ± 1.63 VS 5.42 ± 2.41 at 30 min, p = 0.015; 2.81 ± 1.58 VS 4.19 ± 2.09 at 3 hours, p = 0.005; 2.23 ± 1.20 VS 3.23 ± 1.86 at 6 hours, p = 0.015) and moving (mean ± SD = 6.45 ± 1.69 VS 7.26 ± 2.21 at 30 min, p = 0.111; 5.00 ± 1.79 VS 6.48 ± 1.86 at 3 hours, p = 0.002; 4.35 ± 1.38 VS 5.35 ± 1.70 at 6 hours, p = 0.014). There were no significant different in cumulative morphine consumption between intravenous paracetamol and placebo group despite total cumulative morphine consumption for intravenous paracetamol group was lower than placebo group (mean ± SD = 14.65 ± 10.12 VS 20.61 ± 14.33, p = 0.063). Incidence of side effects was similar between the two groups. Conclusion: This study show beneficial effects of perioperative intravenous paracetamol as part of multimodal analgesia for patients who have lower limb bone fractures going for orthopaedic procedures. We recommended the use of intravenous paracetamol as part of multimodal analgesia in treating postoperative pain.
format Thesis
qualification_level Master's degree
author Muda, Mohd Izwan Azmi
author_facet Muda, Mohd Izwan Azmi
author_sort Muda, Mohd Izwan Azmi
title Perioperative intravenous paracetamol as adjunctive treatment for postoperative pain relief after orthopaedic surgery involving lower limb bone fracture
title_short Perioperative intravenous paracetamol as adjunctive treatment for postoperative pain relief after orthopaedic surgery involving lower limb bone fracture
title_full Perioperative intravenous paracetamol as adjunctive treatment for postoperative pain relief after orthopaedic surgery involving lower limb bone fracture
title_fullStr Perioperative intravenous paracetamol as adjunctive treatment for postoperative pain relief after orthopaedic surgery involving lower limb bone fracture
title_full_unstemmed Perioperative intravenous paracetamol as adjunctive treatment for postoperative pain relief after orthopaedic surgery involving lower limb bone fracture
title_sort perioperative intravenous paracetamol as adjunctive treatment for postoperative pain relief after orthopaedic surgery involving lower limb bone fracture
granting_institution Universiti Sains Malaysia
granting_department Pusat Pengajian Sains Perubatan
publishDate 2016
url http://eprints.usm.my/43255/1/Dr.%20Mohd%20Izwan%20Azmi%20Muda-24%20pages.pdf
_version_ 1747821188052156416

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