Tags

Type your tag names separated by a space and hit enter

Pain and Multimodal Analgesia in Laparoscopic Cholecystectomy.
Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2022 Jul 13; 43(2):41-49.P

Abstract

Background: The administration of high doses of opioids during surgery can lead to higher postoperative pain scores at rest and when coughing. Multimodal analgesia may lower the need for opioids during surgery and the suffering of postoperative pain. Multimodal analgesia can be achieved by providing non-opioid drugs (lidocaine, ketamine, and magnesium sulfate), three different types of drugs. Each of these drugs as different analgesic effects and they belong to three different pharmacological groups. The aim of this study is to develop a better understanding of the effects of each drug (lidocaine, ketamine, and magnesium sulfate) on postoperative analgesia, the needs for rescue analgesics, and analyze the total amount of fentanyl during the intraoperative period in patients undergoing laparoscopic cholecystectomy. Methods: 120 patients were enrolled in this randomized controlled study. They were classified as ASA 1 and 2 and were scheduled for laparoscopic cholecystectomy. They were further divided into 3 groups. Group 1, or the lidocaine group, had received lidocaine at 1 mg/kg and a continuous intravenous infusion with lidocaine at 2 mg/kg/h. Group 2, or the ketamine group, received ketamine at 0.5 mg/kg. Group 3, or the magnesium sulfate group, received a continuous intravenous infusion of magnesium sulfate at 1.5 gr/kg. The intensity of postoperative pain was assessed using a VAS score at rest and when coughing, with evaluation at 1, 4, 8, 12, and 24 hours, postoperatively. Also, the needs for rescue analgesics and the total amount of fentanyl during the intraoperative period in all groups was also followed. Results: The patients from the lidocaine group had the highest scores of pain in the postoperative period at rest and when coughing, and the ketamine group had the lowest pain scores. Rescue analgesia was given the most to lidocaine group, and less so in the magnesium group. The magnesium group received the highest dose of fentanyl during surgery and the lowest dose was received by patients from the lidocaine group. Conclusion: Multimodal analgesia can lower the need for opioids in the intra- and postoperative period after laparoscopic cholecystectomy.

Links

Publisher Full Text (DOI)

Authors+Show Affiliations

Toleska M
University Clinical Center "Mother Teresa" Skopje, University Clinic for TOARILUC -Department for Anesthesiology, Reanimation and Intensive Care (KARIL), Medical Faculty - Skopje, University ″Ss. Cyril and Methodius″ Skopje, RN Macedonia.
Dimitrovski A
University Clinical Center "Mother Teresa" Skopje, University Clinic for TOARILUC -Department for Anesthesiology, Reanimation and Intensive Care (KARIL), Medical Faculty - Skopje, University ″Ss. Cyril and Methodius″ Skopje, RN Macedonia.
Shosholcheva M
University Clinic "St. Naum Ohridski" Skopje, Medical Faculty - Skopje, University ″Ss. Cyril and Methodius″ Skopje, RN Macedonia.
Kartalov A
University Clinical Center "Mother Teresa" Skopje, University Clinic for TOARILUC -Department for Anesthesiology, Reanimation and Intensive Care (KARIL), Medical Faculty - Skopje, University ″Ss. Cyril and Methodius″ Skopje, RN Macedonia.
Kuzmanovska B
University Clinical Center "Mother Teresa" Skopje, University Clinic for TOARILUC -Department for Anesthesiology, Reanimation and Intensive Care (KARIL), Medical Faculty - Skopje, University ″Ss. Cyril and Methodius″ Skopje, RN Macedonia.
Dimitrovska NT
University Clinical Center "Mother Teresa" Skopje, University Clinic for Thoracic and Vascular Surgery, Medical Faculty -Skopje, University ″Ss. Cyril and Methodius″ Skopje, RN Macedonia.

MeSH

AnalgesiaAnalgesicsAnalgesics, OpioidCholecystectomy, LaparoscopicDouble-Blind MethodFentanylHumansKetamineLidocaineMagnesiumMagnesium SulfatePain MeasurementPain, Postoperative

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

35843915

Citation

Toleska, Marija, et al. "Pain and Multimodal Analgesia in Laparoscopic Cholecystectomy." Prilozi (Makedonska Akademija Na Naukite I Umetnostite. Oddelenie Za Medicinski Nauki), vol. 43, no. 2, 2022, pp. 41-49.
Toleska M, Dimitrovski A, Shosholcheva M, et al. Pain and Multimodal Analgesia in Laparoscopic Cholecystectomy. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2022;43(2):41-49.
Toleska, M., Dimitrovski, A., Shosholcheva, M., Kartalov, A., Kuzmanovska, B., & Dimitrovska, N. T. (2022). Pain and Multimodal Analgesia in Laparoscopic Cholecystectomy. Prilozi (Makedonska Akademija Na Naukite I Umetnostite. Oddelenie Za Medicinski Nauki), 43(2), 41-49. https://doi.org/10.2478/prilozi-2022-0017
Toleska M, et al. Pain and Multimodal Analgesia in Laparoscopic Cholecystectomy. Pril (Makedon Akad Nauk Umet Odd Med Nauki). 2022 Jul 13;43(2):41-49. PubMed PMID: 35843915.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pain and Multimodal Analgesia in Laparoscopic Cholecystectomy. AU - Toleska,Marija, AU - Dimitrovski,Aleksandar, AU - Shosholcheva,Mirjana, AU - Kartalov,Andrijan, AU - Kuzmanovska,Biljana, AU - Dimitrovska,Natasha Toleska, Y1 - 2022/07/13/ PY - 2022/7/17/entrez PY - 2022/7/18/pubmed PY - 2022/7/20/medline KW - ketamine KW - laparoscopic cholecystectomy KW - lidocaine KW - magnesium sulfate KW - postoperative pain SP - 41 EP - 49 JF - Prilozi (Makedonska akademija na naukite i umetnostite. Oddelenie za medicinski nauki) JO - Pril (Makedon Akad Nauk Umet Odd Med Nauki) VL - 43 IS - 2 N2 - Background: The administration of high doses of opioids during surgery can lead to higher postoperative pain scores at rest and when coughing. Multimodal analgesia may lower the need for opioids during surgery and the suffering of postoperative pain. Multimodal analgesia can be achieved by providing non-opioid drugs (lidocaine, ketamine, and magnesium sulfate), three different types of drugs. Each of these drugs as different analgesic effects and they belong to three different pharmacological groups. The aim of this study is to develop a better understanding of the effects of each drug (lidocaine, ketamine, and magnesium sulfate) on postoperative analgesia, the needs for rescue analgesics, and analyze the total amount of fentanyl during the intraoperative period in patients undergoing laparoscopic cholecystectomy. Methods: 120 patients were enrolled in this randomized controlled study. They were classified as ASA 1 and 2 and were scheduled for laparoscopic cholecystectomy. They were further divided into 3 groups. Group 1, or the lidocaine group, had received lidocaine at 1 mg/kg and a continuous intravenous infusion with lidocaine at 2 mg/kg/h. Group 2, or the ketamine group, received ketamine at 0.5 mg/kg. Group 3, or the magnesium sulfate group, received a continuous intravenous infusion of magnesium sulfate at 1.5 gr/kg. The intensity of postoperative pain was assessed using a VAS score at rest and when coughing, with evaluation at 1, 4, 8, 12, and 24 hours, postoperatively. Also, the needs for rescue analgesics and the total amount of fentanyl during the intraoperative period in all groups was also followed. Results: The patients from the lidocaine group had the highest scores of pain in the postoperative period at rest and when coughing, and the ketamine group had the lowest pain scores. Rescue analgesia was given the most to lidocaine group, and less so in the magnesium group. The magnesium group received the highest dose of fentanyl during surgery and the lowest dose was received by patients from the lidocaine group. Conclusion: Multimodal analgesia can lower the need for opioids in the intra- and postoperative period after laparoscopic cholecystectomy. SN - 1857-8985 UR - https://www.unboundmedicine.com/medline/citation/35843915/Pain_and_Multimodal_Analgesia_in_Laparoscopic_Cholecystectomy_ DB - PRIME DP - Unbound Medicine ER -