Perioperative pain management during laparoscopic cholecystectomy: randomized controlled study
DOI:
https://doi.org/10.15587/2519-4798.2018.122135Keywords:
postoperative pain, laparoscopic cholecystectomy, dexmedetomidine, lidocaine, ketamine, randomized controlled trialAbstract
Aim. Aim of this article was to review current literature regarding perioperative pain management for laparoscopic cholecystectomy.
Methods. The single-center, controlled study was carried out at the department of surgery, anesthesiology and intensive care, Postgraduate Institute of Bogomolets National Medical University. Eligible participants were assigned to intervention groups (Group D; n=30; Group K, n=30; Group L, n=30) or control (Group C; n=30). Group D received dexmedetomidine infusion 0,5 mcg/kg/h from induction in anesthesia to extubation, group L received lidocaine bolus 1mg/kg and infusion 2mcg/kg/h, group K received ketamine bolus 0,5mg/kg and infusion 0,25 mg/kg/h, group C (control) received normal saline infusion.
Results. Dexmedetomidine, lidocaine and ketamine infusion was associated with lower incidence of severe postoperative pain, morphine consumption and significantly higher time to first rescue analgesia. Also patients in group D, L, K had lower intraoperative fentanyl and sevoflurane consumption.
Conclusions. Postoperative pain management after LCE remains one of the most significant challenges. Intraoperative dexmedetomidine, ketamine and lidocaine infusion may be effective and safe to improve analgesia during LCE. Hovewer further controlled randomised studies are requeired for accurate conclusions
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