Implicaciones de los diferentes modelos analgésicos en los marcadores inflamatorios tras colecistectomía laparoscópica

Abstract

BackgroundDespite the advantages of laparoscopic surgeries, its induced shoulder and abdominal pain are significant, ranging from 35% to 80%. The cause of post laparoscopic pain is not fully understood and supposed to be multifactorial and possibly referred to as pain. Aim of the studyEvaluate the effect of different analgesic models on post-laparoscopic pain and inflammatory markers modulation. MethodsPatients scheduled for elective laparoscopic cholecystectomy randomLy assigned to receive local infiltration of the hepatic and right subdiaphragmatic fossae with one of four types of the analgesic mixture of drugs:-Group-1 (G1): 20 mL of (bupivacaine 0.25%) Group-2 (G2): 20 mL of (bupivacaine 0.25% + 3 mg of Morphine sulphate) Group-3 (G3): 20 mL of (bupivacaine 0.25% + 3 mg of Morphine sulphate + 200 microgram/kg ketamine). Group-4 (G4): 20 mL of isotonic saline as the control group. ResultsGroup 3 demonstrated significant low VNRS of shoulder pain and significantly low levels of inflammatory marker compared with the other three groups. Highest statistically significant levels of inflammatory markers recorded in the control group among the study groups. No side effects or complications documented in the four study groups. ConclusiónThe addition of Ketamine and Morphine to the Bupivacaine for hepatic and subdiaphragmatic insufflation produced good analgesia and reduced the levels of inflammatory markers after Laparoscopic cholecystectomy.