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2013, Number 3

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Cir Cir 2013; 81 (3)

Infusional therapy: an alternative for shouder pain post-laparoscopy

Ureña-Frausto CA, Plancarte-Sánchez R, Ramírez-Aranda JM, Reyes-Torres JI

Language: Spanish
References: 39
Page: 187-195
PDF size: 120.88 Kb.


ABSTRACT

Introduction: Neuraxial anesthesia in upper abdominal laparoscopic surgery decreases perioperative morbidity and mortality however, the shoulder pain is a common and difficult to control; major opioid (eg fentanyl) for the control of this event may depress respiratory function, 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 pain 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. Variables 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.


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