Urmi Mittal Dave

Abstract

Introduction: Paracetamol is used as an analgesic in mild to moderate pain over opioidsor NSAIDs due to lack of significant side effects. Intravenous Paracetamol is available as vial (150 mg/ml, 20 ml) and ready-to- use pint (1gm/100 ml) in market. Considering cost difference between the two formulations, we decided to conduct this study to assess analgesic efficacy against cost effectiveness between paracetamol vial and paracetamol pint. Materials and Methods: Sixty female patients, aged 18-35 years, American Society of Anaesthesiologist physical status I–III, posted for elective or emergency caesarean section under subarachnoid block were enrolled in the study. The patients were randomly allocated into two groups of 30 patients each. In Group A, IV P aracetamol (Febrinil vial,150mg/ml, by MANISH Pharmaceuticals) 6.5 ml (1gm) from vial diluted in 100 ml normal saline infused over 15 minutes and in Group B, IV Paracetamol 100 ml pint (1 gm/100 ml, by ABBOTT Pharmaceuticals) was given over 15 minutes at the time of skin closure followed by subsequent doses at 6 hourly interval in both the groups. Patients were observed for analgesia efficacy, requirement of rescue analgesia, hemodynamic stability and side effects if any. Cost effectiveness of both formulations was noted. Results: Demographic profile, visual analogue score, number of rescue analgesia and haemodynamic were comparable in both the groups (p > 0.05). No major complications were noted except nausea, vomiting, pain at injection site. But there was large difference in the cost of Paracetamol per dose between the two groups (33.66 rupees in group A vs 262 rupees in group B). Conclusion: We conclude that paracetamol is a safe and effective treatment option in post-caesarean pain without any major side effects. Considering total dose of 4 gm/24 hrs, Paracetamol vial formulation is more cost effective and equally efficacious analgesic as compared to ready to use Paracetamol pint. Keywords: Analgesia, Cost effectiveness, Formulation, Paracetamol, Post-operativeAnalgesia, Cost effectiveness, Formulation, Paracetamol, Post-operative.

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