37. A Comparative Study of IV Fentanyl versus IV Paracetamol for Pain Relief in Postoperatively After Cardiac Surgery
Objective: To compare the efficacy of IV acetaminophen and IV fentanyl for pain reduction after cardiac surgery.
Study Design: Randomized Controlled Trial study.
Place and Duration of Study: This study was conducted at the Department of Anesthesia, Nishtar Hospital Multan, and Shaikh Zaid Hospital Rahim Yar Khan, from March, 2019 to February, 2021.
Materials and Methods: Total 76 patients underwent cardiac surgery requiring general anesthesia. A Visual Analog Scale (VAS) on 0-10 scales was used for assessment of pain. The scores for pain assessment were given as 0 for no pain, 1-4 for mild, 5-7 for moderate and 8-10 for severe pain. Patient’s pain score was recorded by the same author that recorded the intraoperative observations, after 5, 15, and 30 minutes after surgical procedure. If the score on the numerical rating score was greater than 3, rescue analgesia fentanyl 25 μg was administered in increments.g was administered in increments. Total dose of fentanyl used was also recorded. SPSS version 23 was used for data analysis. Numerical variables like age and VAS score were analyzed and presented as mean and SD. Categorical variables like age were presented as frequency and percentages. Tests of significance student’s t-test and chi square test were applied to see association among variables. P value ≤ 0.05 was considered as significant.
Results: Mean pain score was 1.66 ± 0.74 and 2.16 ± 0.88 in fentanyl and paracetamol groups, respectively, and the difference was statistically significant (p =0.010). QoR score was 14.63 ± 1.34 and 15.34 ± 1.38 in fentanyl and paracetamol groups, respectively, and the difference was of statistical significance (p =0.026). Nausea was reported by 36.8 % patients of the fentanyl group and 26.3 % of the paracetamol group, however, the difference was not statistically significant (p = 0.324). Vomiting was reported by 34.2 % patients of the fentanyl group and 13.2 % of the paracetamol group, and the difference was statistically significant (p = 0.031). Complaint of dry mouth was present in 52.6 % patients of the fentanyl group and 28.9 % of the paracetamol group, and the observed difference was of statistical significance (p = 0.036).
Conclusion: It can be concluded from the results of our study that, IV paracetamol was not associated with significant pain reduction as compared to IV fentanyl however it was safer in terms of dry mouth and vomiting.
Key Words: Fentanyl, Paracetamol, Intravenous, Postoperative, Cardiac Surgery, Pain score, adverse effects, Efficacy
Citation of article: Khan NA, Sattar MK, Adnan M, Khan Z, Mohsin MU, Ammar A. A Comparative Study of IV Fentanyl versus IV Paracetamol for Pain Relief in Postoperatively After Cardiac Surgery. Med Forum 2021;32(4):149-152.