Intraperitoneal pethidine versus intramuscular pethidine for the relief of pain after laparoscopic cholecystectomy: randomized trial
| Autor: | D. C. Moriarty, Deirdre M O’Hanlon, Gerry McEntee, Jackie Ragheb, Sallyann Colbert, Frank Chambers |
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| Rok vydání: | 2002 |
| Předmět: |
Adult
Male medicine.medical_specialty Meperidine Nausea medicine.medical_treatment Injections Intramuscular Drug Administration Schedule Statistics Nonparametric Cholelithiasis medicine Humans Pain Measurement Probability Bupivacaine Analysis of Variance Pain Postoperative Dose-Response Relationship Drug business.industry Middle Aged Surgery Pethidine Analgesics Opioid Treatment Outcome Cholecystectomy Laparoscopic Anesthesia Ambulatory Vomiting Intractable pain Cholecystectomy Female medicine.symptom business Injections Intraperitoneal medicine.drug Abdominal surgery Follow-Up Studies |
| Zdroj: | World journal of surgery. 26(12) |
| ISSN: | 0364-2313 |
| Popis: | Laparoscopic cholecystectomy is widely used and may be performed as an ambulatory procedure. We undertook a randomized comparison of the benefits of intraperitoneal pethidine compared with intramuscular pethidine for postoperative analgesia following laparoscopic cholecystectomy. A series of 100 consecutive American Society of Anesthesiologists (ASA) I or II patients were randomly assigned to intramuscular pethidine (54 patients) or intraperitoneal pethidine (46 patients). Each was combined with intraperitoneal bupivacaine. The primary endpoints were the pain and nausea scores at intervals after operation. All recruited patients completed the study. Pain scores at rest and upon movement were significantly lower in the group receiving the intraperitoneal pethidine at each of the time periods examined (pain at rest at 4 hours: 1.6 +/- 0.8 vs. 2.4 +/- 0.9 cm; p0.001; pain upon movement at 4 hours: 2.1 +/- 0.9 vs. 3.1 +/- 1.2 cm; p0.001). The total dose of pethidine administered via patient-controlled analgesia (PCA) during the first 24 hours after surgery was also significantly lower in this group (total dose 50.9 +/- 3.9 vs. 55.9 +/- 4.4 mg; p0.001). There were no significant differences in the respiratory rate at any of the time periods. Intraperitoneal pethidine analgesia was superior to an equivalent dose of intramuscular pethidine for the relief of postoperative pain in patients undergoing laparoscopic cholecystectomy. This was achieved at the expense of increased nausea but no significant increase in vomiting. The accessibility of this route of analgesia administration has implications for patients undergoing laparoscopic procedures, particularly with the recent trend toward increased use of ambulatory techniques. |
| Databáze: | OpenAIRE |
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