Effect of intravenous preoperative versus postoperative paracetamol on postoperative nausea and vomiting in patients undergoing strabismus surgery: A prospective randomized study.

OBJECTIVE

This prospective randomized study aimed to compare the efficacy of preoperative versus postoperative paracetamol on postoperative nausea and vomiting (PONV) in children undergoing strabismus surgery.

METHODS

Ninety-six patients were randomly divided into three equal groups (n=32). In the preoperative paracetamol group, patients received intravenous (IV) infusion of paracetamol [15 mg kg-1 (1.5 ml kg-1)] 1 h before surgery over 20 min and that of saline (1.5 ml kg-1) in the recovery room. In the postoperative paracetamol group, patients received IV infusion of saline (1.5 ml kg-1) 1 h before surgery over 20 min and that of paracetamol [15 mg kg-1 (1.5 ml kg-1)] in therecovery room. In the control group, patients received the IV infusion of saline (1.5 ml kg-1) pre- and postoperatively. Postoperative pain condition was evaluated using the Faces Pain Scale. In the recovery room, an observer recorded the pain score, complaints of nausea and vomiting, the need for rescue analgesics, and the need for antiemetic drug during 24 h postoperatively.

RESULTS

The incidence of nausea and vomiting during the first 0-6 h postoperatively was significantly lower in the preoperative paracetamol group than in the control and postoperative paracetamol groups (p<0.001). The number of patients requiring antiemetic administration during the first 0-6 and 6-12 h postoperatively was found to be higher in the control group than in the other groups (p<0.001, for all).

CONCLUSIONS

The preoperative administration of paracetamol reduces PONV incidence in children undergoing strabismus surgery.