Analgesic Effects of Intravenous Paracetamol versus Intravenous Magnesium Sulphate in Patients undergoing Major Abdominal and Upper Limb Surgeries under General Anaesthesia: A Randomised Clinical Study

Introduction: Effective postoperative pain management is essential for patient recovery and satisfaction. Intravenous (i.v.) paracetamol and magnesium sulfate are two options that have shown promise in reducing pain and opioid use. Aim: To compare the efficacy of intraoperative i.v. magnesium sulfa...

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Main Authors: Raj Bahadur Singh, Saurav Shekhar, Shivani Sinha, Siddharth Singh, Anand Dev, Mohd Asim Rasheed
Format: Article
Language:English
Published: JCDR Research and Publications Private Limited 2025-05-01
Series:Journal of Clinical and Diagnostic Research
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Online Access:https://jcdr.net/articles/PDF/20944/78394_CE[Ra1]_F(SHU)_PF1(AG_SL)_PFA(IS)_PB(AG_IS)_PN(IS).pdf
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Summary:Introduction: Effective postoperative pain management is essential for patient recovery and satisfaction. Intravenous (i.v.) paracetamol and magnesium sulfate are two options that have shown promise in reducing pain and opioid use. Aim: To compare the efficacy of intraoperative i.v. magnesium sulfate versus i.v. paracetamol on postoperative analgesic requirements in major surgeries under general anaesthesia. Materials and Methods: This prospective randomised clinical study was conducted in the Department of Trauma and Emergency at Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India, and included 100 patients classified as American Society of Anaesthesiologists (ASA) grade I and II. The patients were assigned to two groups: Group P received 20 mg/kg i.v. paracetamol, and Group M received 20 mg/kg i.v. magnesium sulfate in 100 mL of normal saline. Written consent was obtained from all the participants. Baseline parameters were monitored and a standardised general anaesthesia protocol was followed. Postoperatively, pain was assessed using the Visual Analog Scale (VAS) and analgesic requirements and adverse effects were recorded. Statistical analysis was conducted using the t-test via GraphPad Prism (Dotmatics, GraphPad Software, San Diego, California). Results: A comparison of pain scores revealed similar levels immediately after surgery (Group P: 7.1, Group M: 7.2) and at six hours postsurgery (Group P: 2.1, Group M: 2.0). At 12 hours, Group M reported higher pain (6.8) compared to Group P (6.2), but pain levels were comparable at 18 hours (Group P: 3.0, Group M: 3.1). There was no significant difference in the number of rescue analgesia injections used (Group P: 2.0, Group M: 1.9, p-value=0.348). Diclofenac consumption was higher in Group P (300 mg) compared to Group M (290 mg, p-value=0.00526). The time to the first rescue analgesic was longer in Group M (5.2 hours) compared to Group P (4.6 hours, p-value=0.023). Adverse effects such as nausea, vomiting, sedation and respiratory depression were similar between groups, with no significant differences. Conclusion: The i.v. paracetamol and magnesium sulfate provided comparable postoperative pain relief. Group P had lower pain levels at 12 hours, while Group M required less diclofenac and had a longer time to the first rescue analgesic. Adverse effects were similar, making both drugs effective options for pain management.
ISSN:2249-782X
0973-709X