title: Effect of vitamin C on morphine use after laparoscopic cholecystectomy: a randomized controlled trial.
abstract: OBJECTIVE
  We designed a randomized double-blind placebo-controlled trial to assess the role of a single prophylactic dose of vitamin C (2 g) po in reducing the consumption of opioids postoperatively in patients undergoing laparoscopic cholecystectomy.
  
  
  METHODS
  Eighty adult patients were allocated to receive 2 g vitamin C po or placebo approximately one hour prior to induction of anesthesia. Following laparoscopic cholecystectomy, patients received morphine patient-controlled analgesia for 24 hr. The following data were assessed postoperatively in the postanesthesia care unit at two, four, six, 12, and 24 hr: morphine consumption, verbal numerical rating scale scores for incisional pain and nausea/vomiting, and pruritus and sedation scores. The primary outcome measure was 24-hr morphine consumption. Patient satisfaction was assessed before hospital discharge.
  
  
  RESULTS
  Morphine consumption was significantly lower in the vitamin C group vs the placebo group [16.2 (10.7) and 22.8 (13.8) mg, respectively; difference = 6.6 mg; 95% confidence interval, 1.1 to 12.1 mg; P = 0.02]. There was no difference in pain scores or side effects between the two groups. Satisfaction scores were similar in both groups.
  
  
  CONCLUSIONS
  Our study showed that supplementation with vitamin C (2 g) po decreased morphine consumption in the postoperative period in patients undergoing laparoscopic cholecystectomy.
authors.affiliation: Department of Anesthesiology, American University of Beirut Medical Center, Beirut, Lebanon.
authors.forename: Ghassan E
authors.initials: GE
authors.lastname: Kanazi
authors.forename: Mohammad F
authors.initials: MF
authors.lastname: El-Khatib
authors.forename: Vanda G
authors.initials: VG
authors.lastname: Yazbeck-Karam
authors.forename: Janane E
authors.initials: JE
authors.lastname: Hanna
authors.forename: Badiaa
authors.initials: B
authors.lastname: Masri
authors.forename: Marie T
authors.initials: MT
authors.lastname: Aouad
mesh_terms: D000328:Adult; D016058:Analgesia, Patient-Controlled / Q000379:methods; D000701:Analgesics, Opioid / Q000008:administration & dosage; D001205:Ascorbic Acid / Q000008:administration & dosage / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic / Q000379:methods*; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009020:Morphine / Q000008:administration & dosage*; D010149:Postoperative Pain / Q000517:prevention & control*; D017060:Patient Satisfaction; D011300:Preoperative Care; D013997:Time Factors; D016896:Treatment Outcome; D014815:Vitamins / Q000008:administration & dosage / Q000627:therapeutic use
chemical_list: D000701:Analgesics, Opioid; D014815:Vitamins; D009020:Morphine; D001205:Ascorbic Acid