To compare intravenous paracetamol with tramadol given pre-emptively for intraoperative and postoperative analgesia- A randomized controlled trial

Introduction: The recommended approach for postoperative pain management is to initiate the treatment with analgesics such as paracetamol, NSAIDS, and aspirin followed by adjunctive use of opioids to treat more acute pain symptoms. However, the adverse effects associated with opioids and NSAIDS are well established. Aim: To study the efficacy of paracetamol in comparison to Tramadol when used as analgesic component of balanced anesthesia, pre-emptively for intraoperative and postoperative purpose. To study their side effects. To find out which of these two drugs is better in providing intraoperative and postoperative analgesia with minimum side effects. Materials and Methods: 60 patients of either sex, divided using computer generated random number table into 2 equal groups. Group T: (n 30): Tramadol hydrochloride group, Group P: (n 30): Paracetamol group. The dose of paracetamol and tramadol hydrochloride was 15mg/kg and 2mg/ kg body weight respectively. Statistical analysis: analysis was done by SPSS software version 11 by using Z test, chi-square test, proportion test (Z). P value less than 0.05 was considered as significant and less than 0.0001 as highly significant. Results: Both the groups were comparable with respect to their demographic profile, ASA status, and surgical procedures. Both paracetamol and tramadol have a good analgesic action and fewer side effects. The mean score of VAS Scale in group P (1.86  2.40) and group T (3.03  2.42) was similar and difference was not statistically significant. Also the side effects were comparable in both groups. Total number of rescue analgesics required by the group P (1.6) was significantly less as compared to the group T (3.7) with Z value = 4.00, p < 0.0001. Conclusion: Paracetamol has a better efficacy than tramadol hydrochloride in providing intra-operative and post-operative analgesia, when used pre-emptively with reduced number of doses of analgesic and almost no side effects.