title: A comparative study of intravenous paracetamol and fentanyl for pain management in ICU.
abstract: Pain in ICU patients should be managed effectively and safely. Fentanyl and Paracetamol are used frequently in ICU. However experience using IV Paracetamol in the setting of critically ill patients is limited. We evaluated the analgesic effect and adverse reactions of intravenous Paracetamol compared to Fentanyl in ICU patients with mild to moderate pain. Forty patients in a general ICU were randomized into two groups of IV Paracetamol and IV Fentanyl in a single blinded fashion. Pain was assessed by Visual Analogue Scale (VAS) before drug administration and six hourly for 48 h of 1 g IV Paracetamol every 6 h for 48 h in the first group and 25 μg Fentanyl intravenously every three hours for 48 h in the second group. Patients were monitored for significant adverse reactions particularly of CNS and hepatic nature. Results showed the age, sex and pain score before analgesia was matched in both groups. Pain scores were similar in both groups at 24 h 2.60 (± 1.2) and 2.40 (± 1.5) and at 48 h 2.25 (± 0.96) and 2.05 (± 1.1) in Paracetamol and Fentanyl groups respectively. Clinical and laboratory adverse reactions were also similar in both groups. The analgesic properties of Paracetamol and Fentanyl were similar in this study. We did not observe any significant adverse effects in the two groups. Clinical and laboratory findings including liver functions remained without any statistically significant difference in two groups. This study demonstrates intravenous Paracetamol may be as safe and effective as Fentanyl in ICU patients with mild to moderate pain.
authors.affiliation: Emam Hossein Hospital, Shahid Beheshti Medical University, Tehran, Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Kouchek
authors.forename: Behnam
authors.initials: B
authors.lastname: Mansouri
authors.forename: Majid
authors.initials: M
authors.lastname: Mokhtari
authors.forename: Reza
authors.initials: R
authors.lastname: Goharani
authors.forename: Mir Mohammad
authors.initials: MM
authors.lastname: Miri
authors.forename: Mohammad
authors.initials: M
authors.lastname: Sistanizad
keywords: IV Paracetamol; IV fentanyl; Pain; Side effects