Intravenous acetaminophenvs oral ibuprofen in combination with morphine PCIA after Cesarean delivery

• Published in: Canadian journal of anesthesia Vol. 53; no. 12; pp. 1200 - 1206
• Main Authors: Alhashemi, Jamal A., Alotaibi, Qamar A., Mashaat, Manal S., Kaid, Tarek M., Mujallid, Razaz H., Kaki, Abdullah M.
• Format: Journal Article
• Language: English
• Published: Toronto Springer Nature B.V 01.12.2006
• Subjects: Cesarean section; Patient satisfaction
• ISSN: 0832-610X; 1496-8975
• DOI: 10.1007/BF03021581

To compare the effects ofiv acetaminophen with those of oral ibuprofen with respect to postoperative pain control and morphine requirements in patients receiving morphine patient-controllediv analgesia (PCIA) after Cesarean delivery. Forty-five term patients scheduled for Cesarean delivery were randomized to receive acetaminophen 1 giv every six hours plus oral placebo (group A) or ibuprofen 400 mgpo every six hours plusiv placebo (group I); the first dose of study drug was given 30 min preoperatively. Postoperatively, all patients received PCIA for 48 hr using morphine bolus dose 2 mgiv, lockout interval ten minutes, and no basal infusion. Visual analogue scale (VAS; 0 to 10) at rest and morphine requirements were recorded every hour for four hours then every four hours for a total of 48 hr postoperatively. Patient satisfaction was recorded on a ten-point scale (from 1 to 10) 48 hr postoperatively. Visual analogue scale scores decreased similarly in both groups over time, however, there were no differences between groups at any time during the study period (estimated marginal means: 1.4 ± SEM 0.2vs 1.9 ± SEM 0.2 for groups A and I, respectively,P = 0.124). Cumulative doses of postoperative morphine were 98 ± 37vs 93 ± 33 mg for groups A and I, respectively (P = 0.628). Patient satisfaction with analgesia was high in both groups (9 ± 1vs 9 ± 1,P = 0.93). Intravenous acetaminophen is a reasonable alternative to oral ibuprofen as an adjunct to morphine patient-controlled analgesia after Cesarean delivery.[PUBLICATION ABSTRACT]