Effect of intravenous acetaminophen versus fentanyl on postoperative pain after transurethral lithotripsy

Zolhavarieh, Seyed Mohammad; Mousavi-Bahar, Seyed Habibollah; Mohseni, Maede; Emam, Amir Hossein; Poorolajal, Jalal; Majzoubi, Faeze

doi:10.1016/j.bjane.2018.06.005

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Revista Brasileira de Anestesiologia

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Scientific Articles • Rev. Bras. Anestesiol. 69 (2) • Mar-Apr 2019 • https://doi.org/10.1016/j.bjane.2018.06.005 copy

Effect of intravenous acetaminophen versus fentanyl on postoperative pain after transurethral lithotripsy^☆ ☆ Iranian Registry No: IRCT201204309597N1 (www.irct.ir).

Authorship SCIMAGO INSTITUTIONS RANKINGS

Abstract

Background:

Postoperative pain is the most common postoperative complication. This study was conducted to assess the effect of acetaminophen versus fentanyl on postoperative pain relief in patients who underwent urologic surgeries.

Methods:

This clinical trial was conducted on patients aged 18–65 years. Patients were randomly assigned to receive either 2000 mg acetaminophen (propacetamol) or 2 mcg.kg^-1 fentanyl intravenously, 15 min before the end of surgery. The postoperative pain was evaluated every 6 h for 24 h using the Visual Analog Scale. Total morphine dose taken in 24 h and hemodynamic status were evaluated.

Results:

Eighty patients were enrolled into the trial. The mean score of pain in 6, 12, 18, and 24 h after surgery was lower in the acetaminophen group than in the fentanyl group but the difference was not statistically significant except in 12 and 18 h after surgery (p < 0.05). The amount of administered morphine was higher in the fentanyl group than in the acetaminophen group, but the difference was not statistically significant. The hemodynamic status including systolic and diastolic blood pressure and heart rates were nearly the same in the two groups but the SpO₂ mean was significantly higher in the acetaminophen group than the fentanyl group.

Conclusions:

This trial indicated that intravenous acetaminophen is as effective as intravenous fentanyl in pain relief after urologic surgeries (transurethral lithotripsy).

KEYWORDS
Acetaminophen; Fentanyl; Morphine; Postoperative pain; Hemodynamic parameters; Transurethral lithotripsy

Characteristics	Acetaminophen (n = 40)		Fentanyl (n = 40)		p-Value
	Number	Percent	Number	Percent	p-Value
Education level					0.485
Illiterate	3	7.50	3	7.50
Primary school	8	20.00	13	32.50
Secondary school	6	15.00	8	20.00
High school	14	35.00	12	30.00
Academic	9	22.50	4	10.00
Having chronic disease					0.615
No	37	92.50	39	97.50
Yes	3	7.50	1	2.50
Drug usage for chronic disease					0.615
No	37	92.50	39	97.50
Yes	3	7.50	1	2.50
ASA ^a a American Society of Anesthesiologists Classification. class					0.615
PC-I	37	92.50	39	97.50
PC-II	3	7.50	1	2.50

Postoperative signs and symptoms (h)	Acetaminophen (n = 40)		Fentanyl (n = 40)		p-Value
	Mean ± SD		Mean ± SD
Pain (Visual Analog Scale; 0-10)
0	0.00 ± 0.00		0.00 ± 0.00		1.000^a
1	0.05 ± 0.32		0.00 ± 0.00		0.320^a
6	2.98 ± 3.6		4.04 ± 3.16		0.165^a
12	2.23 ± 2.93		3.78 ± 3.37		0.031^a
18	1.25 ± 1.72		2.53 ± 2.98		0.022^a
24	0.78 ± 1.58		1.00 ± 1.60		0.529^a
Peripheral oxygen saturation (SpO ₂ %)
0	95.90 ± 1.72		95.43 ± 2.04		0.263^a
1	96.43 ± 2.45		95.98 ± 2.08		0.379^a
6	96.85 ± 1.63		95.90 ± 1.66		0.012^a
12	96.63 ± 1.98		96.08 ± 1.82		0.199^a
18	96.95 ± 1.32		96.20 ± 1.77		0.035^a
24	97.10 ± 1.17		96.40 ± 1.74		0.038^a
	Number	Percent	Number	Percent	p-Value
Frequency of morphine use
0	0	0.00	0	0.00	1.000^b
1	0	0.00	0	0.00	1.000^b
6	9	22.50	13	32.50	0.317^b
12	8	20.00	16	40.00	0.051^b
18	3	7.50	4	10.00	0.692^b
24	0	0.00	1	2.50	0.314^b
Morphine rescue dose (mg)	2.5 ± 3.39		4.25 ± 5	0.071^a

Sociedade Brasileira de Anestesiologia R. Professor Alfredo Gomes, 36, 22251-080 Botafogo RJ Brasil, Tel: +55 21 2537-8100, Fax: +55 21 2537-8188 - Campinas - SP - Brazil
E-mail: bjan@sbahq.org

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[1] * Corresponding author. E-mail:dsmbszolhavarieh@gmail.com (S.M. Zolhavarieh).

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Effect of intravenous acetaminophen versus fentanyl on postoperative pain after transurethral lithotripsy☆ ☆ Iranian Registry No: IRCT201204309597N1 (www.irct.ir).

Abstract

Background:

Methods:

Results:

Conclusions:

Effect of intravenous acetaminophen versus fentanyl on postoperative pain after transurethral lithotripsy^☆ ☆ Iranian Registry No: IRCT201204309597N1 (www.irct.ir).