Outcome of Multimodal Preemptive Analgesic with Intravenous Paracetamol, Tramadol and Lignocaine Combination on Postoperative Analgesia

Abstract

Background: Post-operative pain management is very important as it is a critical component of perioperative outcomes in different surgeries. Till now, opioid is the only drug used widely, but there are side effects like respiratory depression and longer hospital stays. Preemptive multimodal analgesia may reduce the perioperative analgesic dose and side effects. This study aimed to investigate the effect of preemptive intravenous paracetamol, tramadol, and lignocaine combination on postoperative analgesia.
Methods: This observational study was carried out in the Department of Anaesthesia, Intensive Care and Pain Medicine, Shaheed Suhrawardy Medical College, Dhaka. Patients aged 18-65 years with with ASA-I and ASA-II scheduled for general anesthesia for various surgery were included. All study participants were infused a combination of 15 mg/kg intravenous paracetamol, tramadol 50 mg, and 40 mg lignocaine 10 minutes before surgery. The hemodynamic status, post-operative analgesic consumption, duration of analgesia and any adverse effects were documented.
Results: A total of 60 patients were enrolled in this study. The mean age was 41.5 ± 11.8 years, and the male-to-female ratio was 1:1.8. The average duration of surgery was 83.60± 11.38 minutes. Approximately 35 (58.3%) patients required pethidine at different time periods during the postoperative period. The average total dose was 70.85±12.68 mg. The mean duration of post-operative analgesia was 6.40± 2.38 hours. The hemodynamic status was within the physiological limit during the perioperative period. There were fewer side effects recorded in the post-operative period.
Conclusion: Preemptive multimodal analgesia with a combination of intravenous paracetamol, tramadol and lignocaine is effective in patients undergoing different surgeries under general anaesthesia.