The Effect of Irıtravenous Paracetamol on Morphine Consumption Used for Post-Operative Pain After Modified Radical Mastectomy

Paracetamol is combined with opioids or used alone for management of post-operative pain. In this study, we investigated the effect of intravenous (IV) paracetamol on morphine consumption used for post-operative pain after modified radical mastectomy. SixtyASA l-lll patients scheduled for modified radical mastectomy under general anesthesia were randomly allocated into two groups by using closed envelope system (Group P; n= 30, Group S; n= 30). Anesthesia was induced with fentanil 1-2/vg/kg, cisatracurium 0.15 mg/kg and propofol 2-2.5 mg/kg, maintained with sevoflurane 1-2%, N20 66%/Oz. Group P received paracetamol 1 g, infused in 15 minutes one hour before the end of surgery and at six hours intervals in post-operative 24 hours. Şaline infusion was given to Group S at the same time. Ali patients were connected to a patient controlled analgesia device adjusted to deliver morphine 5 mg as loading, 1 mg bolus and five minutes lock-out time. A bolus of morphine 5 mg was administered if visu-al analog scale (VAS) s 4. l/AS scores, sedation, respiratory rate, heart rate, blood pressure, Sp02, morphine consumption and side effects were recorded. Demographic parameters were similar. Morphine consumption was less in Group P (p< 0.001). The demand and delivery doses of morphine was higher in Group S (p< 0.001). VAS scores were lower in paracetamol group (p< 0.008). Aithough the side effects such as nausea-vomiting, urinary retention and itching were more in Group S, it was not sta-tistically significant. In this study, aithough statistically not significant, we have demonstrated that paracetamol used for post-operative pain can reduce morphine consumption and side effects while providing an effective analgesia.