Can intra-operative methylprednisolone application be effective for post-operative pain, nausea and vomiting in laparoscopic cholecystectomy operations?

Abstract

Background/Aim: Post-operative nausea, vomiting (PONV), and pain are common symptoms after laparoscopic cholecystectomy (LC) that is performed under general anesthesia. These symptoms lead to prolongation of post-operative recovery and hospital stay. In this study, the efficacy of intra-operative methylprednisolone (MP) administration on post-operative pain and PONV was investigated in patients undergoing LC under general anesthesia. Methods: This study was conducted at Uşak University Faculty of Medicine Hospital. Patients who underwent LC under general anesthesia between 01.11.2018 and 01.06.2019 were evaluated using the prospective cohort method. While intra-operative MP was administered to one group of patients who underwent LC (MP group), MP was not administered to the second group (non-MP). The pain was evaluated using the Visual Analog Scale (VAS) while PONV was evaluated with the Verbal Descriptive Scale (VDS in patients at post-operative hours 0, 1, 2, 6, 12, 18, and 24. On the first post-operative day, patient satisfaction was assessed. Results: The study cohort consisted of 76 patients. The VAS was used to measure post-operative pain, and it was discovered that the MP group had significantly reduced VAS values at post-operative hours 0, 1, 2, 6, 12, 18, and 24 (P < 0.001). In the VDS evaluation, no difference between the two groups only at post-operative hour 12 (P = 0.52) was found, while the VDS value was found to be lower in the MP group than in the non-MP group at post-operative hours 0, 1, 2, 6, 18, and 24 (P ˂ 0.001). The mean total analgesic use at post-operative hour 48 was 69.08 (26.91) mg in the MP group and 96.71 (42.38) mg in the non-MP group. The difference was statistically significant (P ˂ 0.001). Conclusion: PONV and discomfort incidence decreased after intra-operative MPadministration. The decrease in these symptoms was positively reflected in post-operativepatient satisfaction.