The intraperitoneal ondansetron for postoperative pain management following laparoscopic cholecystectomy: A proof-of-concept, double-blind, placebo-controlled trial - 17/06/21
, Sherif Boraii c , Ejaz Cheema d, ⁎, 2 , Mohamed Hassan Elnaem e, f, 3 , Tamer Omar g, 4 , Amr Abdelraouf c , Noha O. Mansour h Bienvenue sur EM-consulte, la référence des professionnels de santé.
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Abstract |
Background |
Pain after laparoscopic cholecystectomy remains a major challenge. Ondansetron blocks sodium channels and may have local anesthetic properties.
Aims |
To investigate the effect of intraperitoneal administration of ondansetron for postoperative pain management as an adjuvant to intravenous acetaminophen in patients undergoing laparoscopic cholecystectomy.
Methods |
Patients scheduled for elective laparoscopic cholecystectomy were randomized into two groups (n = 25 each) to receive either intraperitoneal ondansetron or saline injected in the gall bladder bed at the end of the procedure. The primary outcome was the difference in pain from baseline to 24-h post-operative assessed by comparing the area under the curve of visual analog score between the two groups.
Results |
The derived area under response curve of visual analog scores in the ondansetron group (735.8 ± 418.3) was 33.97% lower than (p = 0.005) that calculated for the control group (1114.4 ± 423.9). The need for rescue analgesia was significantly lower in the ondansetron (16%) versus in the control group (54.17%) (p = 0.005), indicating better pain control. The correlation between the time for unassisted mobilization and the area under response curve of visual analog scores signified the positive analgesic influence of ondansetron (rs =0.315, p = 0.028). The frequency of nausea and vomiting was significantly lower in patients who received ondansetron than that reported in the control group (p = 0.023 (8 h), and 0.016 (24 h) respectively).
Conclusions |
The added positive impact of ondansetron on postoperative pain control alongside its anti-emetic effect made it a unique novel option for patients undergoing laparoscopic cholecystectomy.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Pain after laparoscopic cholecystectomy usually delays hospital discharge. |
• | Postoperative use of acetaminophen alone is mostly insufficient to control pain. |
• | Intraperitoneal ondansetron improved the analgesic efficacy of acetaminophen. |
• | Intraperitoneal ondansetron lowered nausea and vomiting frequency post-surgery. |
• | The local anesthetic effect of ondansetron made it a novel option to manage pain. |
Keywords : Ondansetron, 5-HT3 antagonists, Pain, Laparoscopic cholecystectomy
Plan
Vol 140
Article 111725- août 2021 Retour au numéro
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