Background: Non-opioid analgesics, paracetamol and non-steroid anti-inflammatory drugs (NSAIDs) are proposed for pain relief after laparoscopy. We compared perioperative propacetamol (P) and ketoprofen (K) to provide analgesia after laparoscopic cholecystectomy.
Methods: After ethical committee approval, we included 104 ASA I-II patients, without preoperative analgesic drugs, who were scheduled to undergo laparoscopic cholecystectomy. Anaesthesia was standardized using propofol, fentanyl, atracurium, isoflurane and N(2)O 50%. Ketoprofen 100 mg or propacetamol 2 g or a saline drip (a 100-ml unit of saline in 10 min) was infused blindly and randomly. Patients received either ketoprofen (group K1) or propacetamol (group P1) before induction of anaesthesia and saline after surgery, or saline before surgery and ketoprofen (group K2) or propacetamol (group P2) after surgery. Postoperative visual analogue pain scores (VAS 0-100 mm) were recorded during 24 h. If VAS was >30, a second dose (placebo, ketoprofen or propacetamol) was infused. Nalbuphine 0.2 mg kg(-1) i.v. was given as rescue analgesic if VAS was > or =50.
Results: Ninety-eight patients were studied The number of patients not requiring the second analgesic was greater in K1 (33.5%) than the others (K2 0%, P1 0%, P2 7.5%). VAS scores were significantly lower in K1 (P=0.001), with less nalbuphine consumption compared with P1. VAS and opioid request were similar in K2 and P2.
Conclusion: Preoperative administration of ketoprofen improves postoperative analgesia after laparoscopic cholecystectomy compared with its postoperative administration and pre- and postoperative propacetamol.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1093/bja/aei056 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
IoC2 monitoring versus standard practice in reducing opioid consumption in elderly patients undergoing laparoscopic colorectal surgery: a study protocol for a randomised controlled trial.
BMJ Open
January 2025
Department of Anaesthesiology, China-Japan Friendship Hospital, Beijing, Beijing, China.
Introduction: Nociception monitoring has recently gained recognition as a valuable tool for guiding intraoperative opioid administration. Several nociception monitors, including the Surgical Pleth Index, the Index of Consciousness (IoC) and the Nociception Level, have been introduced for managing intraoperative analgesia. While these technologies show promise in initial applications, the effectiveness of IoC2 in guiding pain management during anaesthesia, particularly in elderly patients who require precise opioid use, remains unclear.
View Article and Find Full Text PDFPreoperative posterior quadratus lumborum block: Determining the minimum effective ropivacaine concentration in 90% of patients (MEC90) for postoperative analgesia after laparoscopic myomectomy.
Anaesth Crit Care Pain Med
January 2025
Department of Anesthesiology, Peking University Third Hospital, Beijing, China. Electronic address:
Background: Quadratus lumborum block (QLB) has gained traction as a regional anesthesia technique to manage postoperative pain following laparoscopic surgery. However, the 90% minimum effective concentration (MEC90) of local anesthetics for posterior QLB remains undetermined.
Methods: We conducted a double-blind, comparative dose-finding study involving 54 women scheduled for elective laparoscopic myomectomy under general anesthesia.
Comparison of perioperative analgesic effectiveness of ultrasound-guided erector spinae plane block and transversus abdominis plane block in patients undergoing laparoscopic nephrectomy.
Agri
January 2025
Department of Anesthesiology and Reanimation, Bursa Uludağ University Faculty of Medicine, Bursa, Türkiye.
Objectives: In this study, we aimed to compare the efficacy of two regional anesthesia methods, transversus abdominis plane (TAP) block and erector spinae plane (ESP) block, for intraoperative and postoperative pain relief in patients undergoing laparoscopic nephrectomy.
Methods: Fifty patients aged 18-80 years with American Society of Anesthesiologists (ASA) classification I-II scheduled for elective laparoscopic nephrectomy were included after ethical approval and informed consent. Patients were randomly assigned to either Group TAP (receiving TAP block) or Group ESP (receiving ESP block).
Analgesic efficacy of the external oblique intercostal fascial plane block on postoperative acute pain in laparoscopic sleeve gastrectomy: a randomized controlled trial.
Korean J Anesthesiol
January 2025
Department of Anesthesiology, Ondokuz Mayis University, School of Medicine, Kurupelit, Samsun, Turkey, TR55139.
Background: Laparoscopic sleeve gastrectomy (LSG) causes significant postoperative pain, necessitating effective multimodal analgesia strategies. This study evaluated the efficacy of the external oblique intercostal block (EOIB) in this context.
Methods: This prospective, randomized, controlled, single-blind study conducted between April and December 2023 included 60 patients who underwent LSG.
Intraoperative Administration of Esketamine is Associated with Reduced Opioid Consumption After Laparoscopic Gynecological Surgery: A Randomized Controlled Trial.
Drug Des Devel Ther
January 2025
Department of Anesthesiology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, People's Republic of China.
Purpose: To explore the postoperative opioid-sparing effect and incidence of adverse events of different dosages of intraoperative esketamine administration in patients undergoing laparoscopic gynecological surgery.
Patients And Methods: Patients undergoing elective gynecological laparoscopic operation was enrolled and randomly allocated to lower-dose esketamine group, higher-dose esketamine group, or control group. Patients in the two intervention groups received esketamine doses of 0.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!