A Comparison Between Intravenous Acetaminophen (Paracetamol) and Intravenous Meperidine in Postoperative Pain Reduction of Patients Undergoing Appendectomy


1 Department of Anesthesiology, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, IR Iran

2 Department of Urology, Mashhad University of Medical Sciences, Mashhad, IR Iran



Background: Pain management after surgery is one the most important proceedings after emergency appendectomy but there have been no studies on this issue. Objectives: In this study, effects of intravenous acetaminophen (Apotel) are compared with intravenous pethidine (meperidine) in terms of post-operative pain management. Patients and Methods: In this randomized clinical trial study, forty patients with ASA- class I or II who were candidates for emergency appendectomy were randomly divided into two groups. Induction and maintenance of anesthesia in the two groups were similar. The first group received 15 mg/kg intravenous acetaminophen (Apotel) and the second group received 0.5 mg/kg intravenous meperidine 30 minutes before ending surgery. The patients were asked for post-operative pain control using visual analog scale (VAS) at 1, 2, 6 hours after surgery. They were compared with regard to postoperative analgesic requirements and complications. Results: VAS (visual analog scale) was higher in the meperidine group than Apotel group (P = 0.006). In the meperidine group, in the first 6 hours after surgery, VAS (visual analog scale) was higher than five and analgesics were administered. VAS in the acetaminophen group was lower in the first 6 hours and the need for analgesic was very low. Analgesic requirements were much lower in the Acetaminophen group. Frequency of ileus was higher in the Apotel group (P = 0.023). The patients were similar regarding other adverse effects. Conclusions: Administration of intravenous Acetaminophen before ending appendectomy might be more effective than meperidine in postoperative pain management while having fewer complications.