The study was to evaluate the
analgesic and
opioid-sparing effect of intravenous
paracetamol injections in cardiosurgical patients in the early postoperative period. Adequate
analgesia within the first 12-18 hours of the early postoperative period is very important for a good prognosis of the further course of
pain syndrome and for the reduction of a risk for its progression to its chronic form. In early studies,
propacetamol lowered
morphine use after orthopedic and gynecological operations. The efficacy of
paracetamol used in cardiac surgery has been little studied and the results of the studies are conflicting. The randomized, blind, placebo-controlled study included patients after
aortocoronary bypass surgery, of them 22 patients received
paracetamol and 23 had placebo. The test
drug (perfalgan 100 ml or placebo) was intravenously injected 30 min before extubation and then every 6 hours within succeeding 18 hours. The intensity of the
pain syndrome was rated by a 5-score verbal scale every 2 hours. With
pain score of 2 or more,
promedol was intramuscularly administered in a dose of 10 mg. Inspiratory volume was recorded before extubation and the first administration of a
drug just after extubation and then every 2 hours. The baseline indices did not differ in both groups. Throughout the observation, the inspiratory volume was lower in the
paracetamol group than in the placebo group; however, there was a statistically significant difference (p = 0.012) in the reduction in the manifestations of the
pain syndrome (by 81%) only just after tracheal extubation. During this period, inspiratory volume values were higher in the
paracetamol group; however, a statistically significant (39%) difference between the groups in the mean values was obtained only during and 2 hours after extubation. In the perfalgan group, the mean total use of
promedol was 36% less than in the placebo-group, which was statistically significant (p = 0.019). The early postoperative use of
paracetamol after
myocardial revascularization reduces the intake of
opioids and diminishes the intensity of the
pain syndrome within the first hours after extubation, which promotes a higher thoracic excursion, as confirmed by a statistically significant increase in the maximum inspiratory capacity.