RecruitingNot ApplicableNCT07466108

Hemodynamic Effects of Intravenous Paracetamol in Patients Undergoing Emergency Laparotomy

Hemodynamic Effects of Intravenous Paracetamol in Patients Undergoing Emergency Laparotomy: a Randomized Controlled Trial

Sponsor

Cairo University

Enrollment

90 participants

Start Date

Mar 18, 2026

Study Type

INTERVENTIONAL

Conditions

Hypotension Drug-Induced Paracetamol

Summary

Emergency laparotomy is a high-risk procedure often performed in patients with severe physiological derangements due to sepsis, making perioperative management challenging. Although multimodal analgesia is essential, options are often limited by factors such as hemodynamic instability, renal dysfunction, and coagulopathy. Intravenous paracetamol is commonly recommended for perioperative analgesia because of its opioid-sparing effect, but evidence suggests it may cause hypotension through peripheral vasodilation, particularly in critically ill patients. Most data on this effect come from observational studies, and evidence regarding its intraoperative hemodynamic impact remains limited.

Eligibility

Min Age: 21 YearsMax Age: 65 Years

Inclusion Criteria1

Adult patients, ASA I-III undergoing emergency laparotomy

Exclusion Criteria5

Severe cardiac morbidities (impaired contractility with ejection fraction \< 40%, heart block, arrhythmias, tight valvular lesions)
Hemodynamically unstable patients (defined as patients with MAP \< 65 mmHg or need vasopressor to maintain MAP\>65 mmHg).
Patients with high shock index (heart rate / systolic blood pressure \>1)
Pregnant or lactating women,
Allergy of any of the study drugs

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Interventions

DRUGParacetamol (acetaminophen)

Patients will receive 1 g intravenous paracetamol (prepared by withdrawing 100 mL of paracetamol into two 50 mL syringes). The drug will be infused at a rate of 600 mL/h to be completed over a period of 10 minutes

OTHERPlacebo Control

Patients will receive 100 mL saline 0.9% (prepared by withdrawing 100 mL of saline 0.9% into two 50 mL syringes). The dose will be infused at a rate of 600 mL/h.