Comparison of Paracetamol and Fentanyl for Postoperative Pain and Perioperative Events in Phacoemulsification Cataract Surgery

Abstract

Background: We administered paracetamol and fentanyl at the beginning of phacoemulsification cataract surgery. We think that paracetamol administered alone is as effective as fentanyl in treating pain after cataract surgery with fewer side effects during operation and in post anesthesia care unit (PACU). The goal of this study was to compare to the postoperative pain relief effect of paracetamol and fentanyl and to assess their side effects in PACU.
Methods: This study was a randomized double-blinded clinical trial comprising 160 patients aged 50-80 year old undergoing cataract surgery using phacoemulsification method by local anesthesia and sedation. The patients were randomized to two groups; patients who received 1 gr paracetamol (P group) and who received 1µg/kg fentanyl (F group) at the beginning of operation. The pain, sedation, patients’ satisfaction and complications during surgery and recovery time were assessed.
Results: The mean scores for intraoperative and postoperative pain on the visual analog scale showed no statistically significant differences (P=0.445). The scores of anxiety and pain were not significantly different comparing two groups after the surgery (P =0.574). The mean score of satisfaction was (8.84± 1.096) in P group and (9.48 ± 8.03) in F group (p=0.04). The mean arterial blood pressure in group P was lower comparing with group F (P=0.011). Nausea and vomiting, apnea and arrhythmia did not occur in P group, while 3(3.8%) of patients in group F had apnea and arrhythmia, 4(5%) had nausea, and 3(3.8%) had vomiting. While these differences were clinically significant, only nausea showed statistically significant difference between two groups (P=0.043).
Conclusion: Paracetamol is an effective analgesic for postsurgical pain in patients undergoing cataract surgery and it is safe with no important side effects.