Comparative Study for Preemptive Administration of intravenous infusion of Nefopam Versus Paracetamol in Providing Postoperative Analgesia for Patients Undergoing Anterior and Posterior Vaginal Wall Repairs Under Spinal Anesthesia

The aim of the current study was to evaluate and compare the postoperative analgesic effects of preemptive intravenous (IV) paracetamol and nefopam versus and their effect on the total requested dose of tramadol postoperatively.

60 adult female patients, aged 20–55 years, ASA physical status & and were scheduled for anterior and posterior vaginal wall repair (APR) and assigned in a randomized manner into three groups after spinal anesthesia. In control group, 50 ml of normal saline had been infused intravenously over 15 minutes. In group (P), an intravenous infusion of 1 g paracetamol had been given over 15 minutes. In group (N), an intravenous infusion of 20 mg nefopam in 50 ml normal saline had been given over 15 minutes. Visual analogue scale (VAS) were taken at a constant times postoperatively and the total requested postoperative dose of tramadol had been calculated.

Both paracetamol and nefopam groups are associated with a significant longer time to first request of postoperative analgesic treatment (group N > P > C) (P < 0.05) with a significant reduction in the total required postoperative analgesics. VAS revealed a significantly lower score in Group N and P, compared to group C.

Preemptive i.v. paracetamol and nefopam is a good plan to provide an effective postoperative analgesia following spinal anesthesia in patients undergoing vaginal APR.