A Comparison Between Intravenous Acetaminophen (Paracetamol) and Intravenous Meperidine in Postoperative Pain Reduction of Patients Undergoing Appendectomy

Pain management after surgery is one the most important proceedings after emergency appendectomy but there have been no studies on this issue. In this study, effects of intravenous acetaminophen (Apotel) are compared with intravenous pethidine (meperidine) in terms of post-operative pain management. In this randomized clinical trial study, forty patients with ASA- class I or II who were candidates for emergency appendectomy were randomly divided into two groups. Induction and maintenance of anesthesia in the two groups were similar. The first group received 15 mg/kg intravenous acetaminophen (Apotel) and the second group received 0.5 mg/kg intravenous meperidine 30 minutes before ending surgery. The patients were asked for post-operative pain control using visual analog scale (VAS) at 1, 2, 6 hours after surgery. They were compared with regard to postoperative analgesic requirements and complications. VAS (visual analog scale) was higher in the meperidine group than Apotel group (P = 0.006). In the meperidine group, in the first 6 hours after surgery, VAS (visual analog scale) was higher than five and analgesics were administered. VAS in the acetaminophen group was lower in the first 6 hours and the need for analgesic was very low. Analgesic requirements were much lower in the Acetaminophen group. Frequency of ileus was higher in the Apotel group (P = 0.023). The patients were similar regarding other adverse effects. Administration of intravenous Acetaminophen before ending appendectomy might be more effective than meperidine in postoperative pain management while having fewer complications.