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Abstract    Background and aims: Post operative pain relief is important for decreased morbidity and mortality. It would be easy to compare analgesic efficacy of iv Paracetamol and iv Diclofenac postoperatively in two groups of patients undergoing similar surgeries Modified Radical Mastectomy experiencing similar pain. Methods: After Ethical committee approval, 70 patients undergoing modified radical mastectomy were randomly allocated to one of the two groups, each receiving IV Diclofenac and IV Paracetamol. Each group received the respective analgesic after axillary dissection, 30 minutes prior to reversal. IV Paracetamol 1 Gm. was administered as 100mL (10 mg/mL) proprietary solution over 20 minutes. IV Diclofenac 75 mg was administered in 100 mL saline as an infusion over 20 minutes.After surgery patients were shifted to Post-operative ICU. Analgesia was assessed postoperatively at the following intervals – immediate postop (time 0), 30 minutes, 1 hour, 2 hour from extubation and then at 2 hourly interval for first ten hours after surgery. Fentanyl was administered when the VAS scores crossed 4 and/ or the patient demanded the rescue analgesic. The time when the patient demanded the dosage of rescue analgesic was noted. Results: Pain scores changes during a 6 hour period between two groups were similar, 6 hours after surgery, pain scores were significantly higher with Paracetamol compared to Diclofenac (p<0.05),At 8hrs, 10hrs post extubation pain scores were significantly higher with Diclofenac. Group P patients received rescue analgesic 60-90 minutes prior to the group D (± minutes).The total number of patients demanding rescue analgesic in each of the groups was found to be statistically similar. Conclusion: Both Intravenous Paracetamol and Intravenous Diclofenac have equal efficacy for post operative analgesia following Modified radical mastectomy except duration of analgesia which is longer for Intravenous Diclofenac, as inferred from VAS scores and time of need for rescue analgesic. It appears from our study that IV Paracetamol is good alternative to IV diclofenac for post operative analgesia following Modified radical mastectomy.Keywords: Pain, Analgesia, Visual analogue scale, Paracetamol, Modified radical mastectomy.



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