Evaluation of the pre-emptive effect of Acetaminophen codeine on the pain after liver biopsy

Liver biopsy is one of the most important diagnostic procedures for liver diseases. Pain is the most common complication of liver biopsy and it can lead to clear morbidity. Finding a way to reduce pain of liver biopsy its complication is very important for investigators. There are limited studies on evaluation of pre-emptive effect of acetaminophen on liver biopsy. The aim of this study was to investigate pre-emptive effect of Acetaminophen codeine on the pain of liver biopsy during the first 24 hours after biopsy. This was a double blind randomized clinical trail study from Oct 2007 to Oct 2008 in gastroenterology and liver disease unit of Tohid hospital in Sanandaj. Sample size included all the patients who were candidate for liver biopsy. Forty four patients (23 in experimental group and 21 in placebo group) were enrolled into the study on the basis of randomized blocking method. Exclusion criteria included any contraindication for liver biopsy or need of penetration of needle for two or more times for biopsy. Visual analogue scale (VAS) was used to assess pain after liver biopsy, 0,1,3,6, and 24 hours after biopsy. This study was conducted after approval of Ethical review Committee of Kurdistan University of Medical Sciences and obtaining the informed written consent from the patients. The patients received acetaminophen codeine or placebo one hour before biopsy. Data were analyzed by means of Chi square, t-test, analysis of variances, and nonparametric tests. The mean value of the pains intensity in zero, one, three, six, and twenty four hours after biopsy in experimental group was higher than that of placebo group but there was no significant differences between two groups (P>0.05). Intensity of the pain after liver biopsy in females was higher than in males in the two groups but there was no significant differences between two groups (P>0.05). Comparison of the results of the present study with those of other studies shows that acetaminophen codeine is not effective in reducing the pain of biopsy. Further clinical trail studies for determination of the effect of other analgesics drugs are recommended in the future.