The effect of pain management in laparoscopic cholecystectomy on recovery parameters

Abstract

Aim: We aimed to observe the effects of analgesics used intraoperatively on the postoperative pain and recovery in patients underwent LC . Material and Methods: ASA I-III group, aged 20-85 patients, who underwent LC surgery were included in the study. We denominated as groups the distribution of analgesics used in eight groups: control group(Group C) for patients without intraoperative analgesia; tramadol (Group T); metamizole (Group M); diclofenac (Group D); paracetamol (Group P); tramadol+metamizol (Group TM); tramadol+diclofenac (Group TD); tramadol+paracetamol (Group TP). Analgesics that can provide visual analog scale (VAS) ≤ 4 was considered effective. Additional analgesics were administered to the patients whom VAS was above 4 in recovery room. Recoveries of patients was determined with Aldrete Score. Results: 31 patients control group, in 35 patients tramadol, in 36 patients, metamizole, in 32 patients diclofenac and in 31 patients paracetamol, in 56 patients tramadol+metamizol, in 31 patients tramadol+diclofenac and in 32 patients tramadol+paracetamol were used. In all groups used analgesics, VAS≤ 4 could not be provided in first hour. In the patients used one analgesic alone and two analgesics together, lowest need for additional analgesics was in GP and GTP group within the first one hour. Aldrete scores were lowest in whom did not receive analgesics intraoperatively. Conclusion: We consider that the management of pain in laparoscopic cholecystectomy should be done early postoperative period. All analgesics should be administered on the basis of the knowledge of their pharmacokinetic profiles.