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Rashmi C

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Open access Jul 2026

COMPARISON OF INTRAVENOUS PARACETAMOL VERSUS TRAMADOL FOR POST-OPERATIVE ANALGESIA IN ELECTIVE SURGERIES UNDER GENERAL ANESTHESIA

Objectives: The study aimed to compare the analgesic efficacy, hemodynamic effects, rescue analgesic requirements, and adverse-effect profile of intravenous paracetamol and intravenous tramadol for post-operative pain management in patients undergoing elective surgeries under general anesthesia. Methods: This study is a prospective, randomized, assessor-blinded comparative study performed in the Department of Anaesthesiology at a tertiary care teaching hospital from March 2025 to March 2026. A total of 100 adult patients with American Society of Anesthesiologists physical status I-II undergoing elective surgical procedures under general anesthesia were randomly divided into two groups of 50 patients. At the end of surgery, Group P received intravenous paracetamol 1 g, and Group T received intravenous tramadol 100 mg. The Visual Analog Scale (VAS) was used to assess pain at 1, 2, 4, 6, 8, and 12 h post-surgery. Heart rate, mean arterial pressure (MAP), time to first rescue analgesia, total rescue analgesic consumption, and adverse effects were measured and compared between the groups. Results: There were no significant differences in demographic and clinical baseline characteristics between the groups (p>0.05). The paracetamol group had significantly lower VAS scores at 4, 6, and 8 h postoperatively (p≤0.001). Patients treated with paracetamol had a significantly longer time to first rescue analgesia (8.1±1.6 vs. 6.0±1.4 h; p<0.001) and a significantly reduced consumption of diclofenac in the first 12 post-operative h (84±22 vs. 118±28 mg; p<0.001). From 2 h onward, there were significant decreases in heart rate and MAP in the paracetamol group (p<0.05). There were fewer adverse effects in the paracetamol group, and a higher percentage of patients in the paracetamol group reported no adverse effects (90% vs. 74%, p=0.035). Conclusion: Intravenous paracetamol provided superior post-operative analgesia, prolonged analgesic duration, reduced rescue analgesic requirements, and demonstrated a more favorable safety profile compared to intravenous tramadol. It may be considered an effective and safe alternative for post-operative pain management following elective surgeries under general anesthesia.

SRINIVAS KURAHATTI, Rashmi C, AVINASH KAREKAL · 0 citations
Open access Jul 2026

EFFICACY OF DEXMEDETOMIDINE VERSUS MIDAZOLAM FOR SEDATION IN PATIENTS UNDERGOING REGIONAL ANESTHESIA: A RANDOMIZED CONTROLLED STUDY

Objectives: The objective of the study was to assess the effectiveness and safety of dexmedetomidine versus midazolam for sedation during regional anesthesia surgery. Methods: This prospective randomized comparative interventional study was conducted in the Department of Anesthesiology at a tertiary care hospital from January 2025 to January 2026. 100 adult patients undergoing elective surgeries under regional anesthesia were randomly divided into two groups: Group D (dexmedetomidine, n=50) and Group M (midazolam, n=50). Richmond agitation sedation scale (RASS) was used to evaluate sedation. Intraoperative monitoring of hemodynamic parameters, such as mean arterial pressure and heart rate, was performed. Recovery characteristics, patient satisfaction, requirement for rescue sedation and adverse effects were also assessed. Results: The mean intraoperative RASS score was significantly lower in the Group D than in the Group M (−2.8±0.5 vs. −2.5±0.7; p=0.02). The time required to reach the target sedation level was significantly greater in Group D (9.4±2.6 min vs. 7.8±2.4 min; p=0.003). The scores of patient satisfaction with dexmedetomidine use were significantly greater than with midazolam use (8.5±1.0 vs. 7.9±1.2; p=0.01). Dexmedetomidine was associated with more adverse effects of bradycardia (p=0.08) and hypotension (p=0.46), whereas midazolam was associated with more adverse effects of excessive sedation (p=0.14) and restlessness (p=0.09). Conclusion: Dexmedetomidine and midazolam were both found to be effective sedatives for patients undergoing regional anesthetic. Dexmedetomidine was found to be a more effective sedative, well tolerated, more patient-satisfying and more stable for intraoperative hemodynamic despite its comparatively slower onset of sedation than midazolam.

AVINASH KAREKAL, SRINIVAS KURAHATTI, Rashmi C · 0 citations