COMPARATIVE EVALUATION OF

EFFECTIVENESS OF IV PCM & IV

DICLOFENAC FOR POST OPERATIVE PAIN
RELIEF AFTER GENERAL ANAESTHESIA
Presented by Ross Masood
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ABSTRACT

Laying surgery is a daily occurrence. Even though the motility brought on by surgical treatments has been
decreased, side symptoms such pain, nausea, and vomiting after the surgery are still frequent. Severe
consequences may arise from inadequate management of post-operative pain. The purpose of this study is to
evaluate the hemodynamic effects and intra- and post-operative analgesic effects of intravenous diclofenac
sodium and intracetamol administered prophylactically. Patients were then evaluated for pain management.
When the patient was completely aware and oriented enough to respond to questions following the reversal,
as well as at one, two, four, and six hours after the procedure, the assessment of post-operative pain was
conducted.
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INTRODUCTION

Postoperative pain affects the entire body and can significantly impact recovery and quality of life.
Effective management involves meticulous preoperative planning, perioperative care, and
multimodal analgesic strategies to minimize opioid use and its side effects. Patient-controlled
analgesia (PCA) is a popular method, allowing patients to manage their pain through preprogrammed
doses of analgesics. Despite advances, many patients still experience substantial pain post-surgery,
highlighting the need for improved analgesic practices and comprehensive pain assessment .
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AIMS &
OBJECTIVES

• To compare the analgesic efficacy of injection Paracetamol & injection Diclofenac forpain relief
after general anaesthesics.
• To evaluate level of analgesia and incidence of side effects.
• Number of patients needing rescue analgesic
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LITERATURE
REVIEW
• Silvanto et al. (2007) found that a single 3-g intravenous dose of paracetamol effectively reduced morphine
consumption in the initial hours after tonsillectomy but posed a risk of hepatotoxicity, suggesting the need for
further research to determine the optimal safe dose for post-operative pain management.
• H. Kehlatet et al. (2021) conducted a systematic review of 15 randomized controlled trials, finding that both
intravenous paracetamol and intramuscular diclofenac effectively and safely reduce post-operative pain across
various surgical procedures and patient populations.
• Anurag Bijalwan et al. (2019) found that intravenous paracetamol provided superior and longer-lasting analgesia
with minimal side effects compared to intravenous diclofenac in laparoscopic cholecystectomy patients,
suggesting paracetamol as a more suitable option for postoperative pain management in this context.
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MATERIALS &
METHODS
A randomized, prospective, and comparative study at SGT Medical College & Research Hospital will enroll
80 post-operative patients to compare the efficacy and safety of paracetamol and diclofenac for pain relief.
Forty patients will receive paracetamol, and forty will receive diclofenac, with pain assessed using the visual
analogue scale (VAS) at specified intervals over 24 hours. Patients will undergo thorough pre-anesthetic
assessment and adverse drug effects will be monitored. Written informed consent will be obtained, and ethical
committee approval has been secured.
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MATERIALS &
METHODS
SELECTION CRITERIA
Following patients will be included in the study
Inclusion Criteria: Exclusion Criteria:
Patients posted for General Anaesthesia Patient age <18 >65
Patients with ASA grade I, II Patients with ASA grade III &IV
Patients aged between 18-65yrs Allergy to NSAIDS
Both genders male & female
Surgical duration <90min.
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STATISTICAL
ANALYSIS

A sample size of 80 patients (40 per group) was determined for a study comparing the effectiveness of
intravenous paracetamol and diclofenac for post-operative pain relief after general anesthesia. Data will be
collected and analyzed using SPSS and Graph Pad Prism software to calculate means and standard deviations.
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VAS SCALE
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RESULTS

A study comparing intravenous paracetamol and diclofenac for post-operative pain relief found no significant
differences in patient demographics or surgery duration between the groups. Pain scores (VAS) were
significantly lower in the paracetamol group at multiple time intervals, indicating superior pain management.
No significant differences in pulse rate, systolic and diastolic blood pressure, or the type of surgery were
observed between the groups. Overall, paracetamol showed more effective pain relief compared to diclofenac.
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REFERENCES

• Kehlet H, Holte K. Effect of postoperative analgesia on surgical outcome. British journal of anaesthesia.
2001 Jul 1;87(1):62-72.
• Bijalwan A, Singhal P, Altamash S. A comparative evaluation of analgesic effects of using intravenous
paracetamol versus intravenous diclofenac post-operatively in laparoscopic cholecystectomy patients in
SMIH, department of surgery, Dehradun. International Surgery Journal. 2019 Apr 29;6(5):1716-22.
• Silvanto M, Munsterhjelm E, Savolainen S, Tiainen P, Niemi T, Ylikorkala O, Scheinin H, Olkkola KT.
Effect of 3 g of intravenous paracetamol on post‐operative analgesia, platelet function and liver enzymes
in patients undergoing tonsillectomy under local anaesthesia. Acta anaesthesiologica scandinavica. 2007
Oct;51(9):1147-54.
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