SP1.2.9To Evaluate the Analgesic Efficacy of Intraperitoneal Tramadol Vs Placebo for Post Operative Pain Relief Following Laparoscopic Cholecystectomy, A Double Blind Randomized Control Trial

Abstract Aim To study the effectiveness of intraperitoneal instillation of tramadol for postoperative laparoscopic cholecystectomy (LC) pain relief and improve incidence of adverse effect. Methods Double blinded randomized controlled trial over 1 year. The Ethical Clearance was obtained from Institutional Ethics Committee. 60 patients scheduled for LC were enrolled in the study. Patients were randomly assigned into 2 groups using computer generated random numbers. Group T: Received intraperitoneal tramadol 100 mg (diluted in 20 mls distilled water). Group S: Received 20 ml of intraperitoneal normal saline. Pain was assessed using VAS. The assessment was done at 0, 15, 30, 60 minutes, 4, 8, 12, 16 and 24 hours. Incidence of adverse effect were observed. Results In group T, the mean pain scores at all the intervals were significantly low (p < 0.050) except at 24 hours (p = 0.210). Analgesia requirement was significantly high in group S compared to group T immediate post op, 15, 60 minutes, 8 and 12 hours (p < 0.050). The mean requirement of analgesia immediate post op, 15 minutes, 4 and 8 hours was significantly low in group T compared to group S (p < 0.050). 30% patients in group T did not require analgesia at all compared to S (p < 0.001). Incidence of adverse effects at 4 hours was 43% in group S compared to 40% in group T (p > 0.050). Conclusion Intraperitoneal instillation of tramadol in LC has beneficial effect in terms of postoperative pain relief following LC and lower requirement of analgesia. However, the incidence of adverse effects was comparable in both the groups.

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Analgesic Efficacy and Side-Effect Profile of Paracetamol/Codeine and Paracetamol/Dextropropoxyphene after Surgical Removal of a Lower Wisdom Tooth

Journal of International Medical Research ◽

10.1177/030006058701500204 ◽

1987 ◽

Vol 15 (2) ◽

pp. 83-88 ◽

Cited By ~ 13

Author(s):

S. Sagne ◽

P.-Å. Henrikson ◽

K.-E. Kahnberg ◽

H. Thiiander ◽

S. O. Bertilson

Keyword(s):

Side Effects ◽

Pain Relief ◽

Analgesic Efficacy ◽

Surgical Removal ◽

Side Effect Profile ◽

Wisdom Tooth ◽

Double Blind ◽

Patient Groups ◽

The Mean ◽

Observation Period

A double-blind randomized analgesic trial was carried out on 180 patients undergoing surgical removal of an impacted lower wisdom tooth. The patients took their first dose of either 1000 mg paracetamol plus 60 mg codeine or 650 mg paracetamol plus 65 mg dextropropoxyphene when pain appeared after the decline of the local anaesthesia. If needed, another two doses were available during the observation period (≤10 h). The analgesic efficacy of paracetamol/codeine was overall superior to paracetamol/dextropropoxyphene in all variables. Sufficient pain relief was obtained in most patients. The pain reduction after the first dose was 64% in the group receiving paracetamol/codeine compared with 53% in the group receiving paracetamol/dextropropoxyphene and the mean durations of effect of the first dose were 6.6 and 5.8 h, respectively. Side-effects appeared in all patient groups but were most frequent in women taking paracetamol/codeine.

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A COMPARATIVE STUDY OF POSTOPERATIVE ANALGESIA FROM INTRAPERITONEAL INSTILLATION OF ROPIVACAINE V/S ROPIVACAINE + FENTANYL IN LAPAROSCOPIC CHOLECYSTECTOMY SURGERIES

10.36106/2703754 ◽

2021 ◽

pp. 59-63

Author(s):

Vaibhavi j. Hajariwala ◽

Disha Baxi ◽

Birva Khara ◽

Bhumika Pathak

Keyword(s):

Laparoscopic Cholecystectomy ◽

Adverse Effects ◽

Normal Saline ◽

Pain Perception ◽

P Value ◽

Chi Square ◽

Exact Test ◽

Institutional Ethics ◽

Post Operative Pain ◽

Intraperitoneal Instillation

Background and Aim: This study is designed and conducted to compare the efcacy of intra-peritoneal instillation of ropivacaine to that of a combination of ropivacaine and fentanyl in reducing post-operative pain and the side effects of the same. Aim: To compare the effects of intra-peritoneal instillation of ropivacaine to a combination of ropivacaine and fentanyl on postoperative morbidity in terms of: 1. Post-operative pain 2. Post-operative adverse effects Methods and Material: After approval of the Institutional Ethics Committee (IEC) [IEC/HMPCMCE/105/Faculty/12/107/19] and the Clinical Trials Registry of India [CTRI/2020/04/024616], consenting patients were randomized into two groups of 26 participants each. One group was given intraperitoneal instillation with 15ml of ropivacaine 0.75% diluted in normal saline to make a solution of 45ml and other group was given 15ml of 0.75% ropivacaine with fentanyl 50mcg(1ml) diluted in normal saline to make a solution of 45ml, intra-operatively, and post-operative pain perception and occurrence of adverse effects was recorded. Statistical Analysis: Two sample t-test with equal variances, chi-square test and Fisher's exact test. P value<0.05 was considered signicant Results: Group receiving intraperitoneal instillation of plain ropivacaine was found to have signicantly higher VAS scores and VRS scores (p<0.001) and lesser mean time to requirement of rst-dose of analgesic post-operatively (p<0.001), and lesser incidence of bradycardia (p=0.01) Conclusion: Intraperitoneal instillation of combination of ropivacaine and fentanyl is superior to ropivacaine alone for reducing post-operative pain in patients undergoing laparoscopic cholecystectomy surgery.

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Peritoneal Nebulization of Ropivacaine during Laparoscopic Cholecystectomy: Dose Finding and Pharmacokinetic Study

Pain Research and Management ◽

10.1155/2017/4260702 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 5

Author(s):

Massimo Allegri ◽

Martina Ornaghi ◽

Catherine E. Ferland ◽

Dario Bugada ◽

Yash Meghani ◽

...

Keyword(s):

Laparoscopic Cholecystectomy ◽

High Performance ◽

Controlled Trial ◽

Plasma Concentrations ◽

Analgesic Efficacy ◽

Postoperative Nausea And Vomiting ◽

Dose Finding ◽

Morphine Consumption ◽

Double Blind ◽

Postoperative Morphine

Background. Intraperitoneal nebulization of ropivacaine reduces postoperative pain and morphine consumption after laparoscopic surgery. The aim of this multicenter double-blind randomized controlled trial was to assess the efficacy of different doses and dose-related absorption of ropivacaine when nebulized in the peritoneal cavity during laparoscopic cholecystectomy. Methods. Patients were randomized to receive 50, 100, or 150 mg of ropivacaine 1% by peritoneal nebulization through a nebulizer. Morphine consumption, pain intensity in the abdomen, wound and shoulder, time to unassisted ambulation, discharge time, and adverse effects were collected during the first 48 hours after surgery. The pharmacokinetics of ropivacaine was evaluated using high performance liquid chromatography. Results. Nebulization of 50 mg of ropivacaine had the same effect of 100 or 150 mg in terms of postoperative morphine consumption, shoulder pain, postoperative nausea and vomiting, activity resumption, and hospital discharge timing (>0.05). Plasma concentrations did not reach toxic levels in any patient, and no significant differences were observed between groups (P>0.05). Conclusions. There is no enhancement in analgesic efficacy with higher doses of nebulized ropivacaine during laparoscopic cholecystectomy. When administered with a microvibration-based aerosol humidification system, the pharmacokinetics of ropivacaine is constant and maintains an adequate safety profile for each dosage tested.

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Effect of Nefopam-Based Patient-Controlled Analgesia with and without Fentanyl on Postoperative Pain Intensity in Patients Following Laparoscopic Cholecystectomy: A Prospective, Randomized, Controlled, Double-Blind Non-Inferiority Trial

Medicina ◽

10.3390/medicina57040316 ◽

2021 ◽

Vol 57 (4) ◽

pp. 316

Author(s):

Ki Tae Jung ◽

Keum Young So ◽

Seung Chul Kim ◽

Sang Hun Kim

Keyword(s):

Laparoscopic Cholecystectomy ◽

Adverse Effects ◽

Rating Scale ◽

Analgesic Efficacy ◽

Numeric Rating Scale ◽

Controlled Study ◽

Patient Controlled Analgesia ◽

Double Blind ◽

Randomized Controlled ◽

Lockout Interval

Background and Objectives: We investigated the non-inferiority of patient-controlled analgesia (PCA), using either nefopam alone or combined nefopam-fentanyl for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Materials and Methods: In this prospective, randomized, controlled study, 78 patients were allocated to receive nefopam 240 mg (Group N240) or nefopam 120 mg with fentanyl 600 μg (Group NF), equivalent to fentanyl 1200 μg, with a total PCA volume of 120 mL. Patients were given a loading dose (0.1 mL/kg) from the PCA device along with ramosetron (0.3 mg) and connected to a PCA device with a background infusion rate of 2 mL/h, bolus dose amount set at 2 mL, and lockout interval set at 15 min. Pain scores were obtained using the numeric rating scale (NRS) at 30 min after recovery room (RR) admission, as well as 8 and 24 h postoperatively. The primary outcome was analgesic efficacy evaluated using NRS-rated 8 h postoperatively. Other evaluated outcomes included the incidence rate of bolus demand, rescue analgesic and antiemetic requirements, and postoperative adverse effects. Results: NRS scores were not significantly different between the groups throughout the postoperative period (p = 0.539). NRS scores of group N240 were not inferior to those of group NF at 30 min after RR admission, or at 8 and 24 h postoperatively (mean difference [95% CI], −0.05 [−0.73 to 0.63], 0.10 [−0.29 to 0.50], and 0.28 [−0.06 to 0.62], respectively). Postoperative adverse effects were not significantly different between the two groups (p = 1.000) and other outcomes were also not significantly different between the two groups (p ≥ 0.225). Conclusions: PCA using nefopam alone has a non-inferior and effective analgesic efficacy and produces a lower incidence of postoperative adverse effects compared to a combination of fentanyl and nefopam after laparoscopic cholecystectomy.

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Pain Relief in labour: A randomized controlled trial comparing pentazocine with Tramadol

Nepal Journal of Obstetrics and Gynaecology ◽

10.3126/njog.v3i1.1433 ◽

1970 ◽

Vol 3 (1) ◽

pp. 14-18 ◽

Cited By ~ 3

Author(s):

O Kuti ◽

AF Faponle ◽

AB Adeyemi ◽

AT Owolabi

Keyword(s):

Side Effects ◽

Pain Relief ◽

Drug Administration ◽

Controlled Trial ◽

Analgesic Efficacy ◽

Labour Pain ◽

Double Blind ◽

Active Labour ◽

Good Pain Relief ◽

Randomised Controlled

Aim: To assess and compare the analgesic efficacy and side effects of Pentazocine and Tramadol. Method: This double blind randomised controlled trial was carried out at the labour ward of Wesley Guild Hospital Ilesa Nigeria. One hundred normal pregnant women in active labour at term were randomly assigned to receive either intramuscular Pentazocine 30mg or intramuscular tramadol 100mg, at request for analgesia. Analgesic efficacy was assessed by verbal scales of pain intensity and relief; maternal and neonatal side effects were determined. Results: At 60 minutes after drug administration 47.7% and 30.9% of women, in the pentazocine and tramadol group respectively, experienced moderate to good pain relief. Significantly more women in the pentazocine group (34.1%) than in the tramadol group(14.3%) rated their pain as mild (P < 0.05) sixty minutes after drug administration. Mean time to first subsequent request for analgesia was greater in the pentazocine group (181 minutes vs 113 minutes; P < 0.05). There was no significant differences between the drugs in maternal side effects, labour and neonatal outcomes. Conclusion: Pentazocine provides better pain relief than tramadol in labor. Key words: Labour pain, pentazocine, tramadol doi:10.3126/njog.v3i1.1433NJOG 2008 May-June; 3(1): 14 - 18

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Analgesic Efficacy of Intravenous Paracetamol Plus Tramadol Combination for Pain after Laparoscopic Cholecystectomy: A Double-Blind, Randomized, Placebo-Controlled Trial

Analgesia & Resuscitation Current Research ◽

10.4172/2324-903x.1000120 ◽

2014 ◽

Vol 03 (03) ◽

Author(s):

Khaled El Radaideh Alaa Alhowary

Keyword(s):

Laparoscopic Cholecystectomy ◽

Controlled Trial ◽

Analgesic Efficacy ◽

Double Blind ◽

Intravenous Paracetamol

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Comparative study between transdermal nicotine and melatonin patches on postoperative pain relief after laparoscopic cholecystectomy, a double-blind, placebo-controlled trial

Egyptian Journal of Anaesthesia ◽

10.1016/j.egja.2016.05.002 ◽

2016 ◽

Vol 32 (3) ◽

pp. 299-307 ◽

Cited By ~ 2

Author(s):

Ibrahim M. Esmat ◽

Dina Y. Kassim

Keyword(s):

Laparoscopic Cholecystectomy ◽

Postoperative Pain ◽

Pain Relief ◽

Comparative Study ◽

Controlled Trial ◽

Postoperative Pain Relief ◽

Double Blind ◽

Double Blind Placebo ◽

Transdermal Nicotine

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Effect of intraperitoneal instillation of dexmedetomidine or fentanyl as adjuvants to bupivacaine on fast tracking discharge criteria in patients undergoing ambulatory laparoscopic cholecystectomy: a randomised double-blind control trial

Ain-Shams Journal of Anesthesiology ◽

10.1186/s42077-021-00175-1 ◽

2021 ◽

Vol 13 (1) ◽

Author(s):

Bharti Gupta ◽

Versha Verma ◽

Usha Kumari Chaudhary ◽

Ripudaman Sidhu ◽

Ankita Chandel

Keyword(s):

Laparoscopic Cholecystectomy ◽

Rating Scale ◽

Analgesic Efficacy ◽

Clinical Trial Registry ◽

Double Blind ◽

Rescue Analgesia ◽

Fast Tracking ◽

Analgesia Requirement ◽

Intraperitoneal Instillation ◽

Group B

Abstract Background Postoperative analgesia in laparoscopic cholecystectomy significantly affects the ambulation and discharge of the patient. This study compares fentanyl and dexmedetomidine as adjuvants to bupivacaine in intraperitoneal instillation after LC, in terms of their impact on ambulation, analgesic efficacy and recovery profile. Ninety patients were randomised into three groups with thirty patients in each group; group BF was administered 20 ml of 2 μg/kg fentanyl + 0.25% bupivacaine, group BD received 20 ml of 1μg/kg dexmedetomidine + 0.25% bupivacaine and group B received 20 ml of 0.25% bupivacaine only. After 8 h, Post-Anaesthesia Discharge Scoring System (PADS) scored for determining home readiness. Analgesic profile was assessed using Verbal Rating Scale and rescue analgesia requirement seen. Sedation was scored using Ramsay sedation scoring. Results Group B had significantly higher VRS and rescue analgesia requirements whilst groups BF and BD had a similar analgesic profile. Ramsay sedation scores were significantly higher in group BD when compared to groups BF and B. However, the PADS score remained comparable in all three groups (P = 0.113). The trial was retrospectively registered with the clinical trial registry of India CTRI/2019/07/020466. Conclusion Intraperitoneal instillation of bupivacaine in combination with dexmedetomidine or fentanyl significantly reduces postoperative pain scores in comparison to bupivacaine alone, in patients undergoing ambulatory laparoscopic cholecystectomy. However, fentanyl may be preferred over dexmedetomidine, because it causes less sedation and achieves a better PADS score.

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