Hemodynamic Effects of Intravenous Paracetamol in Patients Undergoing Emergency Laparotomy

Condition(s) studied

Investigational drug(s) / intervention(s)

Paracetamol (acetaminophen): Patients will receive 1 g intravenous paracetamol (prepared by withdrawing 100 mL of paracetamol into two 50 mL syringes). The drug will be infused at a rate of 600 mL/h to be completed over a period of 10 minutes

Placebo Control: Patients will receive 100 mL saline 0.9% (prepared by withdrawing 100 mL of saline 0.9% into two 50 mL syringes). The dose will be infused at a rate of 600 mL/h.

Study summary

Emergency laparotomy is a high-risk procedure often performed in patients with severe physiological derangements due to sepsis, making perioperative management challenging. Although multimodal analgesia is essential, options are often limited by factors such as hemodynamic instability, renal dysfunction, and coagulopathy. Intravenous paracetamol is commonly recommended for perioperative analgesia because of its opioid-sparing effect, but evidence suggests it may cause hypotension through peripheral vasodilation, particularly in critically ill patients. Most data on this effect come from observational studies, and evidence regarding its intraoperative hemodynamic impact remains limited.

Eligibility

Primary outcome measure(s)

• Mean arterial pressure — 10 minutes after infusion of the study drug
  noninvasive mean arterial pressure

Trial sites (1)

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