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Comparison of pharmacologic therapies alone versus operative techniques in combination with pharmacologic therapies for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: A randomized controlled trial

 Hyun-Chang Kim  ;  Young Song  ;  Jong Seok Lee  ;  Myeong Eun Jeong  ;  Yongmin Lee  ;  Jin Hong Lim  ;  Do-Hyeong Kim 
 INTERNATIONAL JOURNAL OF SURGERY, Vol.104 : 106763, 2022-08 
Journal Title
Issue Date
Analgesia ; Cholecystectomy ; Pharmacotherapy ; Pneumoperitoneum ; Surgery
Background: Laparoscopic cholecystectomy (LC) causes moderate pain. Various operative analgesic techniques and pharmacologic treatments can reduce postoperative pain. This single-center, single-surgeon randomized controlled study aimed to assess the efficacy of combined operative analgesic techniques and pharmacologic analgesia in decreasing pain in patients undergoing LC.

Materials and methods: Fifty-nine patients scheduled for LC were assigned into two groups. In the pharmacologic analgesia (P) group (n = 29), patients were treated with pharmacologic intervention, including preoperative celecoxib (200 mg), intraoperative acetaminophen (1 g), and dexamethasone (8 mg). In the operative analgesic treatments with pharmacologic analgesia (OP) group (n = 30), patients were treated with both operative analgesic techniques and pharmacologic analgesia, including low-pressure pneumoperitoneum, intraperitoneal normal saline irrigation, and aspiration of intraperitoneal carbon dioxide. The area under the curve (AUC) of pain score for postoperative 24 h was assessed at 0, 2, 6, and 24 h post-operation. The analgesic requirements and sleep quality at postoperative day 1 were assessed.

Results: The AUC/24 h of pain scores at rest and on cough were lower in the OP group (p < 0.001 and p = 0.001, respectively). The pain scores at rest were lower in the OP group at postoperative 2, 6, and 24 h (p = 0.001, p = 0.001, and p = 0.048, respectively). The pain scores on cough were lower in the OP group at postoperative 2 and 6 h (p = 0.004 and p = 0.008, respectively). Analgesic requirements were comparable. The sleep quality score at postoperative day 1 was higher in the OP group (56 ± 18 vs. 67 ± 15, absolute difference, 10; 95% confidence interval, 2 to 19; p = 0.017).

Conclusions: Combined operative analgesic therapies and pharmacologic analgesia compared to pharmacologic analgesia alone decreased pain scores and increased sleep quality in patients undergoing LC.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Do Hyeong(김도형) ORCID logo https://orcid.org/0000-0003-2018-8090
Kim, Hyun-Chang(김현창)
Song, Young(송영) ORCID logo https://orcid.org/0000-0003-4597-387X
Lee, Jong Seok(이종석) ORCID logo https://orcid.org/0000-0002-7945-2530
Lim, Jin Hong(임진홍)
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