The Effect of Paracetamol on the Patient-Controlled Pain After Coronary Artery Bypass Surgery: A Randomized Clinical Trial Study

Maziar Mahjoubifard; Yalda Moeini; Elham Feizabad; Ali Abdolrazaghnejad

doi:10.18502/jpc.v9i4.8222

Maziar Mahjoubifard Children and Adolescent Health Research Center, Ali-ebn e-Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.
Yalda Moeini Anesthesiology and Critical Care Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
Elham Feizabad Department of Obstetrics and Gynecology, Yas Hospital, Tehran University of Medical Sciences, Tehran, Iran.
Ali Abdolrazaghnejad Department of Emergency Medicine, Khatam-Al-Anbia Hospital, Zahedan University of Medical Sciences, Zahedan, Iran.

DOI: https://doi.org/10.18502/jpc.v9i4.8222

Keywords: Pain; Paracetamol; Fentanyl; Coronary Artery Bypass; Surgery

Abstract

Background: Pain is one of the patients' common problems, and usual morbidity after coronary artery bypass graft (CABG). This study aimed to assess the effect of Paracetamol and fentanyl in reducing post-CABG pain.

Methods: This double-blind randomized clinical trial was conducted on 160 patients undergoing elective CABG (80 in group F (Fentanyl) and 80 in group P (Paracetamol)), at the cardiac surgery department of hospitals affiliated with Zahedan University of Medical Sciences. In group F, 50μg of Fentanyl (intravenous (IV)) was injected followed by a solution of 10 μg/cc at a rate of 4 cc/hr. For patients in group P, 15 mg/kg of Paracetamol (IV) was administered followed by a solution of 25 μg/cc at a rate of 4 cc/hr. Patients have been infused with the named drugs within the first 24 hours after the operation. Pain severity was assessed by the visual pain score (VAS) tool at baseline, and two, four, eight, twelve, and twenty-four hours after the surgery.

Results: The mean of pain score in 12 (P-value=0.002) and 24 (P-value<0.0001) hours after surgery in group P was significantly less than that of group F. The mean heart rate in patients receiving Paracetamol was significantly (P-value = 0.005) less than that of patients receiving Fentanyl for 4 hours after surgery. The mean of increasing creatinine postoperatively in two groups was significant. The mean of increasing AST and ALT postoperatively in group P was significant with no case of liver function impairment.

Conclusion: It seems Paracetamol is a good choice for reducing post-CABG pain with no significant complication, although further and more comprehensive research is needed.