title: Intravenous paracetamol infusion: Superior pain management and earlier discharge from hospital in patients undergoing palliative head-neck cancer surgery.
abstract: BACKGROUND
  Paracetamol; a cyclooxygenase inhibitor; acts through the central nervous system as well as serotoninergic system as a nonopioid analgesic. A prospective, double-blinded, and randomized-controlled study was carried out to compare the efficacy of preoperative 1g intravenous (iv) paracetamol with placebo in providing postoperative analgesia in head-neck cancer surgery.
  
  
  METHODS
  From 2008 February to 2009 December, 80 patients for palliative head-neck cancer surgery were randomly divided into (F) and (P) Group receiving ivplacebo and iv paracetamol, respectively, 5 min before induction. Everybody received fentanyl before induction and IM diclofenac for pain relief at8 hourly for 24 h after surgery. Visual analogue scale (VAS) and amount of fentanyl were measured for postoperative pain assessment (24 h).
  The mean VAS score in 1(st), 2(nd) postoperative hour, and fentanyl requirement was less and the need for rescue analgesic was delayed in ivparacetamol group which were all statistically significant. Paracetamol group had a shorter surgical intensive care unit (SICU) and hospital stay which was also statistically significant.
  
  
  CONCLUSIONS
  The study demonstrates the effectiveness of ivparacetamol as preemptive analgesic in the postoperative pain control after head-neck cancer surgery and earlier discharge from hospital.
authors.affiliation: Department of Anaesthesiology, Nil Ratan Sircar Medical College, Kolkata, West Bengal, India.
authors.forename: Saikat
authors.initials: S
authors.lastname: Majumdar
authors.affiliation: Department of Anaesthesiology, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
authors.forename: Anjan
authors.initials: A
authors.lastname: Das
authors.affiliation: Department of Anaesthesiology, Institute of Post-Graduate Medical Education and Research, Kolkata, West Bengal, India.
authors.forename: Ratul
authors.initials: R
authors.lastname: Kundu
authors.affiliation: Department of Anaesthesiology, Nil Ratan Sircar Medical College, Kolkata, West Bengal, India.
authors.forename: Dipankar
authors.initials: D
authors.lastname: Mukherjee
authors.affiliation: Department of Anaesthesiology, Nil Ratan Sircar Medical College, Kolkata, West Bengal, India.
authors.forename: Bimal
authors.initials: B
authors.lastname: Hazra
authors.affiliation: Department of Anaesthesiology, Bangur Institute of Neurology, Kolkata, West Bengal, India.
authors.forename: Tapobrata
authors.initials: T
authors.lastname: Mitra
keywords: Intravenous paracetamol; postoperative analgesia; surgical intensive care unit