Comparison of analgesic efficacy of intravenous paracetamol and intravenous dexketoprofen trometamol in multimodal analgesia after hysterectomy

We aimed to evaluate analgesic efficacy, opioid-sparing and opioid-related adverse effects of iv paracetamol and iv dexketoprofen trometamol in combination with iv morphine after abdominal hysterectomy. Double-blinded, randomized, placebo controlled, prospective study was designed.Sixty ASA I-II patients scheduled for abdominal hysterectomy were enrolled to study. Patients were randomly divided into three groups as paracetamol, dexketoprofen trometamol and placebo (0.9% NaCl). Intravenous patient-controlled analgesia morphine was used as a rescue analgesic in all groups. Pain scores, hemodynamic parameters, morphine consumption, patient satisfaction and side effects were evaluated. Normal distribution of continuous variables was assessed by Shapiro Wilk test. Significance of differences between groups was analyzed with One Way Analysis of Variances for means and with Kruskal Wallis for medians. Nominal data were evaluated by Pearson’s Chi-Square test. Visual Analog Scale (VAS) scores weren’t statistically significantly different among the groups in all evaluation times, but decrease in VAS scores was statistically significant after the evaluation at 12th hour in all groups. Total morphine consumption (morphine concentration=0.2mg/ml) in group paracetamol (72.3+/-38.0 ml) and dexketoprofen trometamol (69.3+/- 24.1 ml) was significantly lower than group placebo (129.3+/- 22.6 ml). Conclusions: Dexketoprofen trometamol and paracetamol didn’t cause significant change on pain scores but increased patients’ comfort. Although total morphine consumption was significantly decreased by both drugs, side effects were similar among the groups. According to results of the present study routine addition of dexketoprofen trometamol and paracetamol to PCA morphine after hysterectomies is not recommended.