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Paracetamol reduces postoperative pain and rescue analgesic demand after robot-assisted endoscopic thyroidectomy by the transaxillary approach

 Jeong-Yeon Hong  ;  Won Oak Kim  ;  Woong Youn Chung  ;  Joo Sun Yun  ;  Hae Keum Kil 
 WORLD JOURNAL OF SURGERY, Vol.34(3) : 521-526, 2010 
Journal Title
Issue Date
Acetaminophen/therapeutic use* ; Adult ; Analgesics, Non-Narcotic/therapeutic use* ; Chi-Square Distribution ; Double-Blind Method ; Endoscopy/methods* ; Female ; Humans ; Middle Aged ; Pain Measurement ; Pain, Postoperative/drug therapy* ; Prospective Studies ; Robotics ; Statistics, Nonparametric ; Thyroidectomy/adverse effects ; Thyroidectomy/methods* ; Young Adult
Paracetamol ; Postoperative Pain ; Remifentanil ; Postoperative Nausea ; Endoscopic Thyroidectomy
BACKGROUND: Postoperative pain following endoscopic thyroidectomy, although less severe than after open methods, is still a source of marked discomfort and surgical stress. This clinical trial was conducted to determine if repeated intravenous paracetamol could decrease postoperative pain and rescue analgesic requirements after robot-assisted endoscopic thyroidectomy via the transaxillary approach. MATERIALS AND METHODS: This prospective, randomized, double-blinded, and placebo-controlled study enrolled 124 women 21-60 years of age who were scheduled for elective gasless robot-assisted endoscopic thyroidectomy via the transaxillary approach. The patients were given placebo or 1 g of paracetamol as a 100 ml solution infused over 15 min 1 h before the induction of anesthesia, and then at 6-h intervals for the following 24 h. RESULTS: Postoperative pain scores were significantly lower at 1, 3, 6, and 24 h after surgery in the paracetamol group than in the placebo group. Significantly fewer patients in the paracetamol group received rescue analgesics compared to the placebo group (9.5% vs. 65.6%, respectively). First analgesic time was similar in the two groups. Postoperative nausea (44.3% vs. 22.2%) and vomiting (21.3% vs. 6.3%) were more frequent in the placebo group than in the paracetamol group. Other postoperative side effects, including sedation, confusion, and pruritus, were similar in the two groups. CONCLUSIONS: We concluded that repeated administration of 1 g of intravenous paracetamol over 24 h is easy, effective, safe, and well tolerated for pain management in patients with moderate to severe postoperative pain after gasless robot-assisted endoscopic thyroidectomy performed via the transaxillary approach.
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1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kil, Hae Keum(길혜금)
Kim, Won Oak(김원옥)
Chung, Woong Youn(정웅윤)
Hong, Jeong Yeon(홍정연)
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