Rashi Sarna

Abstract

Background and Aims: Pre-emptive paracetamol has been shown to decrease postoperative analgesia requirement in many patient populations; however evidence supporting its role in laparoscopic cholecystectomy is lacking. Our aim was to determine the effect of Pre-emptive paracetamol on postoperative analgesia requirement in patients undergoing laparoscopic cholecystectomy. Materials and Methods: Ninety patients belonging to American Society of Anesthesiologists physical status I or II were randomly assigned to 3 groups. Group I received 1 gram of paracetamol intravenously 30 min prior to surgery; Group II received 1 gram of paracetamol intravenously intraoperatively at time of skin closure and Group III was the control group and did not receive any paracetamol. The postoperative pain scores by VAS and analgesia requirement was compared in the 3 groups’ upto 6 hours postoperatively. Results: The postoperative pain scores remained comparable in the 3 groups for most of the duration of study. The post-operative fentanyl consumption was significantly lesser in Groups I and II as compared to group III. There was no difference in the sedation scores and in the incidence of PONV in the two groups. Conclusion: Pre-emptive intravenous paracetamol is effective in the treatment of postoperative pain after laparoscopic cholecystectomy. Keywords: Pain, Paracetamol.

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Abstract

Subcutaneous emphysema (SE) following general anesthesia though a rare and benign entity, however if extensive can cause tremendous patient discomfort. Development of post operative SE cannot be simply ignored and may indicate possible grave injuries like injury to the airway that might require prompt recognition and management. We report a rare case of postoperative SE after an emergency laparotomy surgery, secondary to an uncommon iatrogenic cause. Keywords: Subcutaneous emphysema, Tracheal injury, Laparotomy, Abdominal drain.

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