Opioid-Sparing Effect of Intravenous Paracetamol After Percutaneous Nephrolithotomy: A Double-Blind Randomized Controlled Trial

Purpose: To evaluate meperidine-sparing effect of intravenous (IV) paracetamol in patients undergoing percutaneous nephrolithotomy (PCNL). Patients and Methods: One hundred patients who underwent PCNL were randomized to paracetamol (n=50) and placebo (n=50) groups. Patients received 100mL of physiologic saline with or without 1g IV paracetamol every 8 hours after PCNL up to 24 hours in the paracetamol and placebo groups, respectively. Patients in both groups received intramuscular meperidine in case of unrelieved pain. The visual analog scale (VAS) was used to evaluate pain intensity scores in the postoperative period. Total meperidine consumption, mean VAS score in the first 6 and 24 hours, demographic variables, operative variables, and side effects were recorded. Results: The mean VAS pain intensity scores at 6 and 24 hours were 50.22 and 41.32mm in the paracetamol and 75.29 or 65.5mm in the placebo group (P<0.001). The mean consumed meperidine dose was 54.40mg and 77.60mg in the paracetamol and placebo groups, respectively (P<0.001). Conclusion: In this study, IV paracetamol significantly reduced total meperidine consumption and pain intensity scores compared with placebo. IV paracetamol can be an effective and safe part of multimodal analgesia regimes for postoperative pain management after PCNL.