A comparison of intravenous paracetamol and intravenous paracetamol with dexmedetomidine for postoperative analgesia management in gynecological surgeries – A prospective randomized double-blinded study

Abstract

Background: Substitution of nonopioid analgesic drugs in place of opioids perioperatively has become mandatory recently due to the development of the opioid crisis. This study emphasizes nonopioid alternatives to significantly reduce perioperative opioid consumption in gynecological surgeries. Objective: This study compared the efficacy of intravenous paracetamol and intravenous (iv) paracetamol with dexmedetomidine in terms of postoperative visual analog scale (VAS) score, sedation score, hemodynamic changes, and analgesic requirement in gynecological procedures. Materials and Methods: This prospective randomized double-blinded study included females between the age of 18 and 60 years who underwent gynecological surgeries. Group P received iv paracetamol 1 g infusion, Group DP received an infusion of iv paracetamol 1 g with dexmedetomidine at a dose of 0.5 μg/kg as infusion 10 min before the end of the surgery over 10 min. VAS score, sedation score, hemodynamic changes, and rescue analgesic requirement were observed up to 12 h postoperatively. Results: Group DP had a significantly lower VAS score in the 4th and 6th h (P = 0.009 and 0.023, respectively). Group P had significantly higher rescue analgesia than Group DP (P = 0.005). Group DP had a significantly higher heart rate than Group P at the 2nd and 4th h (P = 0.001) postoperatively. Group DP had significantly lower mean arterial pressure than Group P at 2 h (P = 0.001). Sedation score among Group DP was significantly higher till 10 h. Conclusion: Combining iv dexmedetomidine and paracetamol effectively reduces postoperative pain, analgesic requirements with good sedation score, and mild hemodynamic changes. Hence, it effectively increases postoperative comfort and reduces hospital stay and cost.