The comparison of intraincisional bupivacaine infiltration and intravenous paracetamol administration for pain alleviation after cesarean section: a double-blinded randomized placebo controlled clinical trial

H. Aksoy, M. Ak, G. Gökahmetoğlu, Ü. Aksoy

Department of Obstetrics and Gynecology, Department of Anesthesiology and Reanimation, Kayseri City Hospital, Kayseri, Turkey. ak-mehmet@hotmail.com

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• Obstetrics

OBJECTIVE: This study aimed to compare the analgesic effect of subcutaneous (SC) bupivacaine and intravenous (IV) paracetamol on postoperative pain and opioid requisites in patients undergoing cesarean delivery.

PATIENTS AND METHODS: One hundred and five women were allocated into 3 groups in this prospective, double-blind, placebo-controlled, randomized trial. Group 1 received SC bupivacaine, Group 2 received IV paracetamol following surgery and every 6 hours for 24 hours in the postoperative period, Group 3 received SC 0.9% saline and IV 0.9% saline at similar periods. Visual analogue scale (VAS) pain scores at rest and coughing, at 15 and 60 minutes, and 2, 6 and 12 hours, and total opioid necessity were measured.

RESULTS: VAS scores at rest were higher in placebo group than in bupivacaine and paracetamol groups at 15 minutes (p=0.047) and 2 hours (p=0.004). VAS scores at coughing were higher in placebo group than in bupivacaine and paracetamol groups at 2 hour (p=0.001) and 6 hours (p=0.018). Placebo group needed higher (p<0.001) doses of morphine than paracetamol or bupivacaine groups.

CONCLUSIONS: Intravenous paracetamol decreases pain scores similar to SC bupivacaine in the postoperative period compared to placebo. Patients taking bupivacaine or paracetamol need fewer opioids than placebo.

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