Acetaminophen as a complement drug on post CABG pain

mansoor Soltanzadeh, Aghigh Heydari, Ahmad Ebadi, Mohammad Ali Ali Sheikhi


Scope and purpose: Pain is one of the important factors making the patients accept and go through surgeries and at the same time, possibly the most important factor involving in the fear from surgery. One of the important postoperative functions is controlling the acute pain to prevent the chronic one. Today, using morphine is one of the most fundamental methods for preventing or treating postoperative pain. However, using these medications is limited due to their complications. Therefore, the present study aims at investigating intravenous acetaminophen efficacy as a supplement to morphine controlling patients’ pain after cardiac surgeries.

Methodology: This study has been a Randomized Clinical Trial on the candidate patients for CABG surgery in Golestan and Imam Khomeini Hospitals. Using randomized block design, the patients were divided into two groups: the treatment group and the placebo group.

The treatment group received 1g intravenous acetaminophen at 6-h intervals over 24 h dose every 6 hours for 24 h and the placebo group normal saline at the same dose. Both groups received morphine based on nurse control criterion with respect to the patients’ clinical symptoms. The scores for pain, nausea and vomiting, relief, and complications were measured in 8, 16, and 24 hours after entering ICU.

Findings: demographic characteristics in the two groups had no significant difference. There was no significant difference between the least pain scores in the first and second 8 hours respectively with the values of P=0.16 and P=0. 58. However, results revealed a significant difference benefiting the treatment group with the value of P=0.02 in the third 8 hours. Measurements for Satisfaction, nausea and vomiting, fear and depression were not significantly different in the two groups; however, relief level and decrease in complications like vertigo, stress, and respiratory failures were significantly different between the groups benefiting the treatment group.

Conclusion: Findings of this study show that intravenous acetaminophen, as a supplement to morphine, is effective in controlling patients’ pain and their relief after cardiac surgeries. In addition, acetaminophen causes less complications such as vertigo, stress, and respiratory failures than the placebo.

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