title: Reduced anaesthetic requirements and postoperative analgesics in patients undergoing laparoscopic cholecystectomy: premedication with intravenous paracetamol versus ketorolac, a double blind and randomised clinical trial.
abstract: OBJECTIVE
  To compare the effects of premedication with intravenous paracetamol versus ketorolac, in decreasing intraoperative anaesthetic and postoperative opioid analgesics requirements in patients undergoing laparoscopic cholecystectomy.
  
  
  METHODS
  An experimental, prospective, comparative, double blind, and randomised clinical trial was conducted to determine intraoperative opioid requirements, and pain and analgesic requirements in the postoperative period in 100 healthy patients undergoing laparoscopic cholecystectomy. They were randomised into 2 groups: Group 1: pre-medicated with paracetamol 1g, and Group 2: with ketorolac 30mg (both administered intravenously 30minutes prior to surgery).
  
  
  RESULTS
  There were no statistically significant differences between groups as regards intraoperative remifentanil use (Group 1: 0.0739±0.016μg/kg/min, Group 2: 0.0741±0.018μg/kg/min). The number of patients in Group 2 that had values of VAS>4 points (22.4%) was lower than in Group 1 (28.6%), but with no statistically significant difference. Of the patients who needed postoperative opioid rescue, most required a single rescue and application of analgesics during hospitalisation, that prevailed between 3 and 12hours, without any significant differences between groups. No adverse effects were observed in the study sample.
  
  
  CONCLUSIONS
  Paracetamol 1g IV given preoperatively decreased anaesthetic requirements and the need for postoperative analgesics similar to the preoperative administration of ketorolac 30mg IV.
authors.affiliation: Servicio de Anestesiología, Hospital General del Este Dr. Domingo Luciani, Caracas, Venezuela. Electronic address: veraadm@gmail.com.
authors.forename: A J
authors.initials: AJ
authors.lastname: Medina-Vera
authors.affiliation: Servicio de Anestesiología, Hospital General del Este Dr. Domingo Luciani, Caracas, Venezuela.
authors.forename: L M
authors.initials: LM
authors.lastname: Novoa
mesh_terms: D000082:Acetaminophen / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage / Q000627:therapeutic use*; D000701:Analgesics, Opioid / Q000008:administration & dosage / Q000627:therapeutic use*; D018685:Anesthetics, Inhalation / Q000008:administration & dosage*; D018686:Anesthetics, Intravenous / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007431:Intraoperative Complications / Q000188:drug therapy; D007530:Isoflurane / Q000008:administration & dosage; D020910:Ketorolac / Q000008:administration & dosage / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage / Q000627:therapeutic use; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D010880:Piperidines / Q000008:administration & dosage; D011184:Postoperative Period; D011229:Preanesthetic Medication; D011446:Prospective Studies; D000077208:Remifentanil
chemical_list: D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D018685:Anesthetics, Inhalation; D018686:Anesthetics, Intravenous; D010880:Piperidines; D000082:Acetaminophen; D009020:Morphine; D007530:Isoflurane; D000077208:Remifentanil; D020910:Ketorolac
keywords: Analgesics, Opioid; Analgésicos, Opioide; Cholecystectomy, Laparoscopic; Colecistectomía, Laparoscópica; Dolor, postoperatorio; Ketorolac; Ketorolaco; Pain, postoperative; Paracetamol; Premedicación; Premedication