title: Premedication With Single Dose of Acetazolamide for the Control of Referral Shoulder Pain After Laparoscopic Cholecystectomy.
abstract: BACKGROUND
  The use of laparoscopic surgeries is escalating thanks to their advantages over the open surgeries. However, several complications can be observed following laparoscopy operation. Postoperative pain is a major concern in cholecystectomy surgeries. Pain can be both experienced in operated areas and radiated to the right shoulder. Acetazolamide is used for glaucoma, acute mountain sickness prophylaxis, and epilepsy in few patients with recurrent epilepsy. It seems that patients' pain can be reduced by preventing carbonic acid production in abdomen after operation.
  
  
  OBJECTIVE
  We aimed at evaluating if administration of acetazolamide preoperatively could affect early or late postoperative pain following laparoscopic surgery.
  
  
  METHODS
  In a randomized-controlled clinical trial study, 70 subjects (30 - 60 years) scheduled for laparoscopic cholecystectomy were included after obtaining a written informed consent. Patients were divided into two groups randomly (intervention and control). The intervention group received 5 mg/kg oral acetazolamide one hour before the operation. The control group did not receive any further medication.
  
  
  RESULTS
  Administration of a single dose of acetazolamide did not have any statistically significant impact on sleep quality (P = 1.000). Moreover, there was no statistically significant difference between groups regarding nausea and vomiting on single dose administration of acetazolamide (P = 1.000). Single dose of acetazolamide was associated with statistically significant decrease in shoulder pain immediately after laparoscopy (P = 0.017). However, there was no statistically significant difference regarding shoulder pain between the studied groups 2, 4, 6, 8, 10, 12, and 24 hours after laparoscopy. Single dose of acetazolamide did not significantly affect analgesic administration in 2, 4, 6, 8, 10, 12, and 24 hours after laparoscopy.
  
  
  CONCLUSIONS
  Single dose of acetazolamide was associated with statistically significant decrease in shoulder pain immediately after laparoscopy. However, this effect was limited to the first postoperative hours and it failed to reduce postoperative pain of right shoulder during 24 hours after the operation.
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Movassaghi
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Ali
authors.initials: A
authors.lastname: Peirovifar
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Davood
authors.initials: D
authors.lastname: Aghamohammadi
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Mohammadipour Anvari
authors.affiliation: Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Samad Ej
authors.initials: SE
authors.lastname: Golzari
authors.affiliation: Department of Anesthesiology, Tabriz University of Medical Sciences, Tabriz, Iran.
authors.forename: Zohreh
authors.initials: Z
authors.lastname: Kourehpaz
keywords: Acetazolamide; Cholecystectomy; Laparoscopic; Premedication; Shoulder Pain