Rectal indomethacin versus intraperitoneal lidocaine for analgesia after laparoscopic cholecystectomy

Abstract

Background: Visceral and shoulder painare among the most frequent reported pain after laparoscopic cholecystectomy (LC). Objectives: To investigate the effectiveness and clinical value of rectal indomecthacin and intraperitoneal lidocaine for treating pain after laparoscopic cholecystectomy. Patients and methods: In Qena university hospital, this prospective randomized comparative study was conducted, 80 patients were scheduled to elective laparoscopic cholecystectomy. Group intraperitonealIP lidocaine (40 patients) received 200 ml saline containing 200 mg 2%lidocaine immediately after pneumoperitoneum, the total solution was sprayed on the upper surface of the liver, right subdiaphragmatic space and around the cholecystectomy site. Group indomethacin (40 patients) received two 100 mg indomethacin rectal suppositories 2 hours prior to surgery. Results: VAS score was significantly lower in indomethacine group ( p value =0.03)over the 24 hours postoperative . The postoperative pethidine requirements were significant lower in group indomethacin mean (34±11.4 mg). Postoperative nausea and vomiting were less in group indomethacin with no statistically significant difference. Conclusion: preoperative rectal indomethacin suppositories decrease postoperative pain scores and analgesics requirements without producing side effects comparing to IP lidocaine in LC. Clinical trail .gov . ID:NCT04964180