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Abstract

Background: Hysterectomy is one of the most commonly performed gynecological surgeries and often leads to significant postoperative pain that can delay recovery if not managed effectively. Ensuring optimal analgesia is vital to enhance patient comfort and minimize complications. Paracetamol and tramadol are frequently used for postoperative pain control, yet their comparative effectiveness and safety profiles remain areas of ongoing clinical evaluation.
Objective: To compare the efficacy and side effect profiles of intravenous paracetamol and tramadol in relieving postoperative pain following abdominal hysterectomy.
Methods: A comparative cross-sectional study was conducted at three tertiary care hospitals in Lahore. A total of 70 patients undergoing elective abdominal hysterectomy were selected through convenience sampling and evenly divided into two groups: 35 received intravenous paracetamol and 35 received intravenous tramadol. Pain intensity was assessed using the Visual Analogue Scale (VAS) at 15 minutes, 30 minutes, 1 hour, and 2 hours postoperatively. Data were also collected on the incidence of adverse effects, patient satisfaction, and the requirement for additional analgesia.
Results: Tramadol demonstrated superior pain relief at 1 hour (VAS: 1.71 ± 0.82 vs. 2.32 ± 0.58; p = 0.01) and 2 hours (VAS: 1.51 ± 0.61 vs. 2.63 ± 0.59; p = 0.01) postoperatively compared to paracetamol. However, 37.1% of patients in the tramadol group experienced nausea and vomiting, 25.7% reported drowsiness, and 17.1% had headaches. In contrast, the paracetamol group had fewer side effects and required more frequent additional analgesia (30% vs. 20%). Patient satisfaction was higher in the tramadol group (85%) than in the paracetamol group (75%).
Conclusion: Tramadol offers more effective short-term analgesia following hysterectomy but is associated with a higher rate of side effects. Paracetamol, while milder in analgesic effect, is better tolerated. Personalized pain management strategies should consider both efficacy and safety to optimize postoperative outcomes.