[Treatment of pain after laparoscopic cholecystectomy].
The characteristics of early pain after laparoscopic cholecystectomy are complex and should be treated in a multimodal fashion. A critical procedure-specific analysis of the evidence suggests a prophylactic analgesic regimen including routine use of preoperative steroids, incisional local anaesthetics and NSAIDs (or COX2-inhibitors) combined with paracetamol for three to four days. Minor modifications of surgical techniques (low insufflation pressure and downsizing of trocars) and preoperative information about the characteristics of early pain after laparoscopic cholecystectomy will add further analgesic benefits to the regimen.
Bisgaard
Thue
T
Kirurgisk Gastroenterologisk Afdeling D, Amtssygehuset i Gentofte, DK-2900 Hellerup. thuebisgaard@tdcadsl.dk
D000082:Acetaminophen / Q000008:administration & dosage; D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D000779:Anesthetics, Local / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects* / Q000379:methods; D016861:Cyclooxygenase Inhibitors / Q000008:administration & dosage; D004359:Drug Therapy, Combination; D006801:Humans; D010149:Postoperative Pain / Q000188:drug therapy* / Q000517:prevention & control; D011229:Preanesthetic Medication
D018712:Analgesics, Non-Narcotic; D000701:Analgesics, Opioid; D000779:Anesthetics, Local; D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D000082:Acetaminophen