Table 1.
Characteristics of all studies included in this review (arranged alphabetically by first Author’s last name).
| Author, Year | Country of Origin | Study Design | Study Sample | Type of Anaesthesia | Intervention | Conclusions |
|---|---|---|---|---|---|---|
| Altenau, 2017 [10] | United States | Randomized, placebo-controlled, double-blind trial | n = 104, pregnant women, scheduled for elective caesarean section, Mean Age 29.6 years | Spinal | - IV paracetamol 1 g given within 30 to 60 min of the surgical incision, and every 8 h for 48 h, for a total of 6 doses | - No significant difference in pain scores but significantly reduced postoperative requirement for opioid. |
| Ayatollahi, 2014 [11] | Iran | Randomized, placebo-controlled, double-blind trial | n = 60, pregnant women, ASA class I, scheduled for elective caesarean section, Age 18 to 40 years | General | - IV paracetamol 1 g given 20 min before induction | - Improved haemodynamic stability after laryngoscopy and intubation. - Lower requirement for postoperative opioid and later first analgesic request. - No significant difference in mean 1-min and 5-min Apgar scores of newborns. |
| Hassan, 2014 [12] | Saudi Arabia | Randomized, two-arm, prospective, unblinded trial | n = 58, pregnant women, ASA class I and II, scheduled for elective caesarean section, Age 18 to 39 years | General | - IV paracetamol 1 g given over 15–20 min, 30 min before induction - IV paracetamol 1 g given over 15–20 min, 30 min before the end of the operation |
- Patients who received preoperative paracetamol had better hemodynamic stability, especially before delivery of the baby. - They also had lower requirements for intra- and postoperative opioids, longer duration of next analgesia needed and lower incidence of postoperative side effects. |
| Ozmete, 2016 [13] | Turkey | Randomized, placebo-controlled, double-blind trial | n = 60, pregnant women, ASA class I and II, scheduled for elective caesarean section, Age 18 to 40 years | General | - IV paracetamol 1 g given 15 min before induction | - Significantly reduced postoperative pain and opioid consumption within 24 h after caesarean section. - No significant difference in Apgar scores and patient side effects. |
| Prasanna, 2010 [14] | Oman | Randomized, two-arm, prospective, blinded trial | n = 80, pregnant women, ASA class I and II, scheduled for elective caesarean section, Mean Age 30.51 years | General | - IM diclofenac sodium 75 mg and IV paracetamol 1 g after induction, before surgical incision - IM diclofenac sodium 75 mg and IV paracetamol 1 g at the end of surgery |
- Patients who received pre-incision analgesia had significantly fewer occurrences of incidental pain and reduced postoperative opioid requirements. |
| Soltani, 2015 [15] | Iran | Randomized, placebo-controlled, double-blind trial | n = 80, pregnant women, ASA class I and II, admitted for urgent caesarean section, Mean Age 28.49 ± 4.63 years | General | - IV paracetamol 15 mg/kg given 15 min before induction | - Significantly blunted heart rate changes following endotracheal intubation and reduced early postoperative pain. - Significantly lower requirements for intra- and postoperative opioids. |
| Towers, 2018 [16] | United States | Randomized, placebo-controlled, double-blind trial | n = 105, pregnant women, scheduled for elective caesarean section, Mean Age 27.1 ± 2.9 years | Spinal | - IV paracetamol 1 g given 15 min before surgical incision | - No difference in postoperative opioid requirements and length of stay postdelivery. - Administration of IV paracetamol did not result in elevated neonate cord blood paracetamol levels |
Abbreviations: American Society of Anaesthesiologists, ASA; intramuscular, IM; intravenous, IV.