1. [Infusional therapy: an alternative for shouder pain post-laparoscopy].
- Author
-
Ureña-Frausto CA, Plancarte-Sánchez R, Reyes-Torres JI, and Ramírez-Aranda JM
- Subjects
- Analgesics, Opioid administration & dosage, Anti-Inflammatory Agents, Non-Steroidal administration & dosage, Drug Therapy, Combination, Female, Fentanyl therapeutic use, Humans, Infusion Pumps, Infusions, Intravenous, Ketoprofen administration & dosage, Ketorolac administration & dosage, Male, Pain Measurement, Pain, Postoperative prevention & control, Pneumoperitoneum, Artificial adverse effects, Respiration Disorders prevention & control, Shoulder Pain etiology, Shoulder Pain prevention & control, Time Factors, Tramadol administration & dosage, Analgesics, Opioid therapeutic use, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Cholecystectomy, Laparoscopic, Ketoprofen therapeutic use, Ketorolac therapeutic use, Nerve Block adverse effects, Pain, Postoperative drug therapy, Preanesthetic Medication, Shoulder Pain drug therapy, Tramadol therapeutic use
- Abstract
Introduction: Neuraxial anesthesia in upper abdominal laparoscopic surgery decreases perioperative morbidity and mortality. However, shoulder pain is common and difficult to control. Use of a major opioid (e.g., fentanyl) for the control of this event may depress respiratory function. This is why we believe that a safe and effective therapeutic control of this disease pain is a multimodal analgesic scheme which we have called infusional therapy., Objective: To compare various schemes for controlling shoulder pain secondary to pneumoperitoneum., Methods: Nonrandomized clinical trial with 56 patients ASA I-II divided into four groups undergoing laparoscopic cholecystectomy. Group I (n= 15) managed with ketorolac 1 mg kg, group II (n = 12) ketoprofen 100 mg, group III (n = 14) ketoprofen 50 mg + 50 mg tramadol, and group IV (n = 15) ketoprofen 100 mg + 100 mg tramadol. The following ariables were analyzed: presence and intensity of pain, analgesia rescue and operative time., Results: Group I had more shoulder pain events compared to other groups (p= 0.002) in the same way the group IV required less rescue analgesia (p= 0.034)., Conclusion: preemptive analgesia to infusional therapy with ketoprofen-tramadol at doses of 100 mg each is safe for laparoscopic surgery.
- Published
- 2013