The Effect of Intraperitoneal Administration of Dexamethasone on Abdominal Pain and Shoulder Pain after Selected Cholecystectomy by Laparoscopic Method

2021 ◽  
Vol 15 (12) ◽  
pp. 3589-3592
Author(s):  
Mahdi Neshan ◽  
Saeed Kargar ◽  
Seyed Mostafa Shiryazdi ◽  
Mohammad Zare ◽  
Abdolhamid Amooei ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Laparoscopic Cholecystectomy ◽  
Shoulder Pain ◽  
Strong Association ◽  
Recovery Period ◽  
Intraperitoneal Administration ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Post Operation ◽  
Random Number Table

Introduction: Laparoscopic cholecystectomy is the standard treatment of cholecystitis. In comparison to open surgery, it has advantages such as a shorter recovery period and a shorter hospital stay. One of the side effects of this treatment is abdominal and shoulder pain after surgery. The purpose of this study was to see how intraperitoneal dexamethasone affects abdominal and shoulder pain following laparoscopic cholecystectomy. Methods and materials: This study included 70 patients aged 18-70 years who were candidate for laparoscopic elective cholecystectomy. Using a random number table, patients were separated into two equal groups. In the first group, after laparoscopy and before trocar removal, 20 cc of ringer serum containing 8 mg dexamethasone was sprayed in the diaphragm and peritoneal cavity, and in the second group, 20 cc ringer was sprayed. Visual analog scale (VAS) pain score was used to assess post operation pain. Results: From 6 o'clock on, there was a substantial difference in abdominal pain between the two groups, with the control group experiencing higher pain. From 12 o'clock onwards, there was a strong association between shoulder discomfort in the two groups, and patients in the control group experienced more pain. Furthermore, the control group received more opioids. Patients in the control group experienced higher nausea and vomiting starting 12 hours after surgery. Conclusion: After laparoscopic surgery, dexamethasone can relieve abdominal and shoulder discomfort, as well as nausea and vomiting, and it can also reduce the need for opioids. Dexamethasone appears to be effective in minimizing postoperative complications. Keywords: Postoperative Pain, Intraperitoneal, Dexamethasone, Laparoscopy

scholarly journals Comparison Postoperative Shoulder Pain, Nausea, and Vomiting Between Low and Normal Pressure Pneumoperitoneum in Laparoscopic Cholecystectomy

2017 ◽  
Vol 2 (2) ◽  
Author(s):  
Behzad Nematihonar ◽  
Hosein Fahimihanzaei ◽  
Mohammadreza Kamranmanesh ◽  
Elham Memary ◽  
Arash Shahbazi ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Shoulder Pain ◽  
Normal Pressure ◽  
Nausea And Vomiting ◽  
Postoperative Shoulder

scholarly journals Preemptive oral paracetamol in laparoscopic cholecystectomy surgery - a comparative study

2014 ◽  
Vol 26 (1) ◽  
pp. 33-38
Author(s):  
Nepal Chandra Saha ◽  
Mehedi Masud ◽  
Mohammad Sofiuddin ◽  
Mushifqur Rahman ◽  
Dilip Kumar Bhowmick ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Sampling Method ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Case Group ◽  
Physical Status ◽  
Pain Scores ◽  
Post Operative Period ◽  
Group I ◽  
Age Range

Background Laparoscopic cholecystectomy causes a considerable pain in the post operative period. Preemptive use of oral paracetamol decreases the intensity of pain and subsequently reduces the dose of opioid as well as nausea and vomiting. Objective The study was designed to observe the effect of preemptive oral paracetamol reduces the dose of postoperative opioid and nausea and vomiting. Methods Fifty patients of ASA physical status I and II, age range 16-50 years and BMI 18.5-24.9 were randomly selected by cards sampling method. They were equally divided into two groups of 25 patients in each group. Group I received vitamin, Group-II received 1 g oral paracetamol 60 min before surgery. In the recovery room dose of opioid was measured in 1, 6, 12, 24 hours and frequency of nausea, vomiting were assessed. Results The total amount of pethidine needed significantly lower in the case group than that in the control group (p = 0.012). The pain scores were comparatively low in case group than that in the control group from beginning to endpoint of evaluation following operation (p = 0.027). The complaint of nausea at 6 and 12 hours was much less in the case group than that in the control group. Majority (80%) of patients in control group demanded analgesic (pethidine) 10 minutes earlier after operation as opposed to only 8% of the control group (p = 0.014). Conclusion Preemptive paracetamol reduces the intensity of postoperative pain and requirements of pethidine to a large extent with no significant side effects. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19814 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 33-38

scholarly journals A randomized clinical trial on the effect of a lidocaine patch on shoulder pain relief in laparoscopic cholecystectomy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ha Yeon Kim ◽  
Jong Bum Choi ◽  
Sang Kee Min ◽  
Min Ying Chang ◽  
Gang Mee Lim ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Shoulder Pain ◽  
Rating Scale ◽  
Patient Characteristics ◽  
Numeric Rating Scale ◽  
Control Group ◽  
Female Patients ◽  
Lidocaine Patch ◽  
And Control ◽  
Patch Group

AbstractThe incidence of laparoscopy-related shoulder pain reaches 90% in women. We evaluated the effect of lidocaine patch 5% on the shoulder pain after laparoscopic cholecystectomy (LC) in female patients. Total 63 female patients were randomly allocated to patch group (n = 31) and control group (n = 32). Patch group received lidocaine patch 5% and dressing retention tape on both shoulder, and control group received only dressing retention tape. Abdominal and shoulder pains were evaluated with rating on numeric rating scale (0 = no pain and 10 = the worst pain) at baseline and at 30 min, 6 h, 24 h, and 48 h after surgery. There were no significant differences in patient characteristics and operation details. The overall incidence of shoulder pain was significantly lower in patch group than in control group (42% vs. 78%, P = 0.005). The severity of shoulder pain also was significantly reduced in patch group compared to control group at 24 h and 48 h after surgery (P = 0.01 and P = 0.015, respectively). Complications related to lidocaine patch were not found except nausea. Lidocaine patch 5% reduced the incidence and severity of postoperative shoulder pain in female patients undergoing LC without complications.

scholarly journals Is Infusion of Subhypnotic Propofol as Effective as Dexamethasone in Prevention of Postoperative Nausea and Vomiting Related to Laparoscopic Cholecystectomy? A Randomized Controlled Trial

2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Mine Celik ◽  
Aysenur Dostbil ◽  
Mehmet Aksoy ◽  
Ilker Ince ◽  
Ali Ahiskalioglu ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Controlled Trial ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Controlled Study ◽  
Control Group ◽  
Double Blind ◽  
Significant Difference ◽  
Group D

Background. Postoperative nausea and vomiting (PONV) is one of common complications in patients undergoing laparoscopic cholecystectomy (LC). Aim of this study was to compare the efficacy of subhypnotic (1 mg/kg/h) infusion of propofol with dexamethasone on PONV in patients undergoing LC.Methods. A total of 120 patients were included in this randomized, double-blind, placebo-controlled study. Patients were randomly assigned to 3 groups; patients of group dexamethasone (group D) were administrated 8 mg dexamethasone before induction of anesthesia, patients of group propofol (group P) were infused to subhypnotic (1 mg/kg/h) propofol during operation and patients of group control (group C) were applied infusion of 10% intralipid. The incidence of PONV and needs for rescue analgesic and antiemetic were recorded in the first 24 h postoperatively.Results. In the 0–24 h, the incidence of PONV was significantly lower in the group D and group P compared with the group C (37.5%, 40%, and 72.5%, resp.). There was no significant difference in the incidence of PONV and use of antiemetics and analgesic between group D and group P.Conclusion. We concluded that infusion of propofol 1 mg/kg/h is as effective as dexamethasone for the prevention of PONV during the first 24 hours after anesthesia in patients undergoing LC.

scholarly journals INTRAPERITONEAL USING OF BUPIVАCAIN FOR THE ANESTHESIA OF PATIENTS AFTER LAPAROSCOPIC CHOLECYSTECTOMY

2018 ◽  
Vol 14 (1-2) ◽  
pp. 54-58
Author(s):  
F.S. Glumcher ◽  
S.O. Solyaryk ◽  
O.V. Oliynyk ◽  
A.I. Kolosovych
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Visual Analog Scale ◽  
Surgical Intervention ◽  
Intraperitoneal Administration ◽  
Control Group ◽  
Average Dose ◽  
Analog Scale ◽  
Pain Evaluation ◽  
The Mean ◽  
Group 1

Relevance. The local anesthetics were used intraperitoneally after some minimally invasive gynecological interventions like a component of postoperative multimodal anesthesia in recent years.   Objective. The aim of  work was to study the effectiveness of intraperitoneal administration  of bupivokain  for the anesthesia of patients after laparoscopic cholecystectomy. Material and methods. 28 patients aged 32-60 years  (16 women, 12 men) were examined. The patients were divided into two groups. In the first group for anesthesia after the operation, was used ketorolac trometamine in dose 0.2 mg/kg intramuscularly each 6 hours. If the patient complained of postoperative pain, which was assessed by Visual-analog scale in 7 points or higher, fentanyl was administered intramuscularly in dose of 0.003 μg/kg. In the second group, besides the components of multimodal anesthesia used in the first group, at the end of the surgical intervention at the drainage tubes were injected 40 ml of 0.125% solution of bupivocaine (50 mg). This injection was repeated throughout the first day each 6 hours. The condition of patients was assessed by a Visual-analog scale after 1, 4, 8, 12 and 24 hours after the finishing of surgery. The average dose of fentanyl in μg/kg used for postoperative anesthesia  first 24 hours after operation was also determined. Results.  We have received a significant reduction in the rates of pain evaluation for Visual-analog scale in patients who used bupivacaine as a component of multimodal anesthesia. One hour after the end of the operation, the pain score for Visual-analog scale was less than the corresponding one in the control group in 1.77 times, after 4 hours – in 1.47, and in 8 hours – in 1.55 times. In all cases, P <0.001. The mean dose of fentanyl used for treatment in the study group was 1.55 times less than that in the control group. There were no significant complications in both groups. A patient in group 1 had nausea, requiring a single dose of ondasetron 2 mg Conclusion. Intraperitoneal administration of bupivocaine had a significant  anesthetic effect after laparoscopic cholecystectomy.

scholarly journals The Safety of Early Administration of Oral Fluid Following General Anesthesia in Children Undergoing Tonsil Operation: A Prospective Randomized Controlled Trial

2020 ◽  
Author(s):  
Meng-Hang Wu ◽  
Chang-qing Liu ◽  
Xiao-qi Zeng ◽  
An-na Jia ◽  
Xiao-rong Yin
Keyword(s):  
General Anesthesia ◽  
Oral Fluid ◽  
Controlled Trial ◽  
Recovery Period ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Early Administration ◽  
Significant Difference ◽  
Tonsil Surgery ◽  
Experimental Group

Abstract Background: The feasibility and safety of giving a small amount of water to children in the recovery period after tonsillectomy under general anesthesia to reduce the thirst and its associated restlessness reaction remain unknown. Methods: This study was approved by our institutional ethics committee, and which adhered to CONSORT guidelines. Pediatric patients undergoing tonsil surgery who met the inclusion and exclusion criteria of our study were randomized into the experimental and control groups. In the experimental group, patients were given a small amount of water instantly after recovering from the general anesthesia, which included the recovery of cough and deglutition reflex, and attaining grade V of muscle strength. The control group was given a small amount of water 4 to 6 hours after the operation. The incidence of nausea and vomiting and the degree of thirst relief were measured and compared between the two groups. Results：300 patients were randomized into each group. There was no significant difference in the incidence of nausea and vomiting 20 minutes after drinking water between the two groups (P>0.05). The thirst score of children over 5 years old in the experimental group was significantly lower than that of the control group (P<0.05). Conclusion: The early administration of a small amount of oral fluid in children undergoing tonsil surgery and recovering from the general anesthesia is not only safe but also effective in reducing postoperative thirst. Trial registration: Current Controlled Trials ChiCTR1800020058, 12-12-2018.

scholarly journals PONV

2015 ◽  
Vol 22 (10) ◽  
pp. 1232-1236
Author(s):  
M. Azeem ◽  
Zia Ullha ◽  
Ahsan Nasim ◽  
M.A. Cheema
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Single Dose ◽  
Controlled Trial ◽  
Randomized Study ◽  
Postoperative Nausea And Vomiting ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Dose Administration ◽  
Medical University ◽  
To Receive

Background: Postoperative nausea and vomiting is reduced if inj Dexamethasoneis given preoperatively in patient undergoing Laparoscopic Cholecystectomy. The aim of thisprospective randomized, controlled trial was to look into effectiveness of dexamethasone beforesurgery may improve nausea, vomiting after surgery in patients undergoing laparoscopiccholecystectomy. Study Design: Prospective randomized study. Setting: Department of Surgery,King Edward Medical University, Lahore - Pakistan. Period: Nov 2010 to April 2012. Methods: 138Patients with Laparoscopic Cholecystectomy were randomized to receive 08 mg Dexamethasone(n=66) or placebo (n=72) intravenously before surgery. Seven patients were excluded on accountof already on steroid treatment due to various reason. Vomiting and nausea were seen in next 24hours after operation. Dexamethasone has minimal side effect after single dose administration. Sixpatients (12%) has nausea and vomiting in treatment group while 26 (47%) in the control group(p<0.001). Patient having dexamethasone, five (10%) need antiemitics as compare to 24 (44%)of those receiving placebo (p<0.001). Conclusion: Single dose of Inj Dexamethasone givenpreoperatively reduce nausea and vomiting markedly in Laparoscopic Cholecystectomy and maybe routinely used in Laparoscopic procedure.

Efficacy of Pregabalin as preemptive analgesic in laparoscopic cholecystectomy

2020 ◽  
Vol 5 (3) ◽  
pp. 1166-1170
Author(s):  
Ajay Singh Thapa ◽  
Rajesh K Yadav
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Nausea ◽  
Postoperative Nausea And Vomiting ◽  
Sedation Score ◽  
Preemptive Analgesia ◽  
Nausea And Vomiting ◽  
Control Group ◽  
Post Operative Period ◽  
The Mean ◽  
Ramsay Sedation Score

Introduction: Different pharmacological approach for preemptive analgesia have been tried with varying degree of success. Preemptive analgesia results in decrease in postoperative opioid requirement and hence decreases opioid related complication. Objectives: This study aims to evaluate pregabalin as preemptive analgesic in scheduled cases. Methodology: Fourty ASA I and II  patients posted for elective laparoscopic cholecystectomy under general anesthesia were divided into two groups of twenty. Group A received pregabalin 300 mg, two hours before induction of anesthesia but group B were not given any medication. Postoperative VAS Score, Ramsay Sedation Score, postoperative nausea and vomiting and postoperative opioid requirement in two groups were observed over 48 hours and noted.Results: The mean VAS scores were  higher in control group whereas the mean Ramsay score was higher in group pregabalin in the first six hours in the post operative period which was statistically significant. The mean Ramsay sedation score was same (2) in both the group after twelve post operative period. Postoperative nausea and vomiting was lower in the pregabalin group. Requirement of post operative analgesia was higher in the control group. Conclusion: Preemptive use of Pregabalindecreasespostoperateive pain, postoperative opioid requirement and increases postoperative sedation.

High-Volume, Low-Concentration Intraperitoneal Bupivacaine Study in Emergency Laparoscopic Cholecystectomy: A Double-Blinded, Prospective Randomized Clinical Trial

2020 ◽  
pp. 155335062091419
Author(s):  
Alpen Yahya Gumusoglu ◽  
Sina Ferahman ◽  
Mehmet Emin Gunes ◽  
Ahmet Surek ◽  
Serhan Yilmaz ◽  
...  
Keyword(s):  
Patient Satisfaction ◽  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Shoulder Pain ◽  
Test Group ◽  
High Volume ◽  
Control Group ◽  
Low Concentration ◽  
Analgesic Consumption ◽  
Intraperitoneal Bupivacaine

Background. Laparoscopic cholecystectomy (LC) often results in postoperative pain, especially in the abdomen. Intraperitoneal local anesthesia (IPLA) reduces pain after LC. Acute cholecystitis–associated inflammation, increased gallbladder wall thickness, dissection difficulties, and a longer operative time are several reasons for assuming a benefit in pain scores in urgent LC with IPLA application. The aim was to determine the postoperative analgesic efficacy of high-volume, low-dose intraperitoneal bupivacaine in urgent LC. Materials and Methods. Fifty-seven patients who were American Society of Anesthesiologists physical status I or II were randomly assigned to receive either normal saline (control group) or intraperitoneal bupivacaine (test group) at the beginning or end of urgent LC. The primary outcome was the postoperative pain score of the Visual Analogue Scale (VAS). The secondary outcomes included Visual Rating Prince Henry Scale (VRS), patient satisfaction, and analgesic consumption. Results. Postoperative VAS scores at the first and fourth hours were significantly lower in the test group than in the control group ( P < .001). Postoperative VRS scores at the first, fourth, and eighth hours were significantly lower in the test group than in the control group ( P < .001, P = .002, P = .004, respectively). Analgesic use was significantly higher in the control group at the first postoperative hour ( P < .001). Shoulder pain was significantly lower, and patient satisfaction was significantly higher in the test group relative to the control group (both P < .001). Conclusion. High-volume, low-concentration intraperitoneal bupivacaine resulted in better postoperative pain control and reduced incidence of shoulder pain and analgesic consumption in urgent LC.

Post-Laparoscopic Cholecystectomy Pain: Effects of Intraperitoneal Local Anesthetics on Pain Control–A Randomized Prospective Double-Blinded Placebo-Controlled Trial

2008 ◽  
Vol 74 (3) ◽  
pp. 201-209 ◽  
Author(s):  
Bestoun H. Ahmed ◽  
Aryan Ahmed ◽  
Dongfeng Tan ◽  
Ziad T. Awad ◽  
Ali Yousef Al-Aali ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Laparoscopic Cholecystectomy ◽  
Controlled Trial ◽  
Open Cholecystectomy ◽  
Isotonic Saline ◽  
Control Group ◽  
Placebo Control ◽  
Saline Irrigation ◽  
Pain Scores ◽  
Significant Difference

Postoperative pain after laparoscopic cholecystectomy (LC) is generally less than open cholecystectomy; however, the postoperative shoulder and abdominal pain experienced by patients still causes preventable distress. Intraperitoneal irrigation of the diaphragmatic surface and gallbladder fossa using normal saline, bupivacaine, or lignocaine may effectively control visceral abdominal pain after an LC. Two hundred patients with similar demographics undergoing elective LC were randomized to one of four groups of 50 patients each, including Group A placebo control, Group B with isotonic saline irrigation, Group C with bupivacaine irrigation, and Group D with lignocaine irrigation. All patients received preperitoneal abdominal wall infiltration with 0.25 per cent bupivacaine to control parietal (somatic) abdominal pain. The visual analogue and verbal rating pain scores at 0, 4, 8, 12 and 24 hours for both shoulder and abdominal pain were recorded in a prospective double-blind fashion at four points during the first 24 postoperative hours. Analgesia requirements, vital signs, blood glucose, and incidence of nausea and vomiting were also recorded. Patients in each group demonstrated a significant difference in visual analogue and verbal rating pain scores and analgesic consumption when compared with controls. Lignocaine controlled pain significantly better than saline or bupivacaine. Bowel function recovery was similar in all patients, and there were no significant complications. We conclude that intraperitoneal irrigation with either saline, bupivacaine, or lignocaine can significantly reduce visceral abdominal pain after LC. Lignocaine was the most efficacious local anesthetic in this trial and has a high safety profile when used at recommended doses.

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