Abstract
Background. Postoperative pain is one of the major challenges of cesarean sections and has many complications such as nausea, vomiting, chills, and hemodynamic disturbance. Therefore, in the present study, we aimed to compare the effectiveness of intravenous Acetaminophen and Ketorolac with Fentanyl for post-cesarean pain control after spinal anesthesia.
Methods. A total of 100 patients who were candidates for cesarean section with spinal anesthesia were included in this study. Patients were divided into two groups of 50 people. Patients in group B received 20 mL of fentanyl mixed with 80 mL of normal saline, and patients in group A received 3 g of acetaminophen and 30 mg of ketorolac in normal saline. Pain score, vomiting, nausea, and sedation were evaluated at different time points, and the data were analyzed using SPSS.
Results. The mean age of patients was 28.63±6.42 years, 28.62±6.68 years in group B and 28.64±6.42 years in group A. There was a significant difference in the pain score between the two groups 6 and 24 hours after surgery. The nausea and vomiting score in group A was significantly lower compared to group B. The mean sedation score in group A was significantly higher compared to group B.
Conclusion. The efficacy of intravenous acetaminophen and ketorolac was similar to that of fentanyl in post-cesarean pain control at 2 and 12 hours; however, this combination was more efficient than fentanyl at 6 and 24 hours and had fewer side effects.
Practical Implications. To manage pain following a cesarean section and potentially other surgical procedures, intravenous acetaminophen and ketorolac can be used instead of fentanyl without increasing complications.