Sugandha Kuttanasari Remani 1 , Aswathy Sarath
BACKGROUND Opioid induced hyperalgesia (OIH) is a state of nociceptive sensitisation caused by exposure to opioids probably due to paradoxical sensitization to painful stimuli. The aim of the study is to study the presence of OIH in acute pain management and to compare the ability of intravenous paracetamol and intravenous dexmedetomidine in allaying OIH in patients receiving epidural Fentanyl following total abdominal hysterectomy. MATERIALS AND METHODS The study was an observational study including sixty patients divided into three groups. All three groups received Epidural Fentanyl as infusion at the rate of 10-15 mcg/hr with intravenous fentanyl bolus as rescue analgesic on Post-Operative Day 1(POD), Group F- On POD 2 received Inj. Fentanyl 50 mcg iv 8th hourly and SOS. Group P- On POD 2 received Inj. Paracetamol 1 gm iv and inj fentanyl SOS. Group D- On POD 2 received Inj. Dexmedetomidine iv as infusion @ 0.02mcg/kg/hr and Inj. Fentanyl SOS. Pain was assessed using visual analogue score (VAS) at 4,12,24,48 hrs and at dressing change on POD 2. RESULTS No statistically significant difference in Pain scores at 4,12,24,48 hrs. Statistically significant difference in pain scores at dressing change was noted in group F ,but no significant difference in VAS between Group P and D.{VAS at dressing change: Group F=4.20; Group P=3.05; Group D=2.70} CONCLUSION PAIN sensed by patients during dressing change was significantly more in patients receiving opioids alone as opposed to a combination of opioids with paracetamol and dexmedetomidine.
