Abstract
ObjectivePostoperative recovery process following laparoscopic cholecystectomy depends on many factors such as pain, fatigue and exhaustion. The objective of this study was to investigate whether the administration of dexamethasone, a glucocorticoid, has positive effects of postoperative patient comfort in patients who underwent laparoscopic cholecystectomy in our clinic.MethodsPatients who presented to the general surgery clinic of our hospital and scheduled for laparoscopic cholecystectomy due to cholelithiasis were included in this study. Patients in Group 1 received dexamethasone 90 minutes before the skin incision, while patients in Group 2 were given placebo (normal saline). Pain scores, presence of nausea and vomiting in the postoperative period were compared between the study and control groups.ResultsNo statistically significant difference was observed between the groups in terms of incisional pain at rest and in motion and visceral pain at rest at postoperative 6th, 12th and 24th hours. Although there was a difference between the groups in terms of visceral pain in motion at the postoperative 12th and 24th hours, this was not statistically significant (p > 0.05). Although the need for additional analgesics and antiemetic drugs was lower in the study group compared to the control group, the difference between the groups was not statistically significant (p > 0.05).ConclusionWe can expect better results with the use of multimodal analgesic and anti-emetic combination instead of a single agent in studies to be performed about the prevention of postoperative pain, nausea and vomiting.
Highlights
Gallstone disease is a commonly seen problem in developed countries
No statistically significant difference was observed between the groups in terms of incisional pain at rest and in motion and visceral pain at rest at postoperative 6th, 12th and 24th hours
There was a difference between the groups in terms of visceral pain in motion at the postoperative 12th and 24th hours, this was not statistically significant (p > 0.05)
Summary
Autopsy and clinical investigations have shown that at least 10% of adults have gallstones. Whereas 40-60% of people with gallstones exhibit a symptomatic clinical course, the majority of patients with symptomatic cholelithiasis have an asymptomatic period. Twenty percent of symptomatic patients with gallstones present with acute cholecystitis picture, while 10% present with complicated cholecystitis (jaundice, cholangitis, pancreatitis), and 60-70% with chronic cholecystitis symptoms [1]. Surgery is a trauma applied on a patient. The organism produces a metabolic and endocrine response against trauma as a result of the stimulation of hypothalamus-pituitary-adrenal axis and sympathetic nervous system [2]. Studies have shown that response given to trauma is proportional to the trauma severity. Minimizing trauma is one of the main goals during surgical interventions [2, 3]
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