The discomfort from a laparoscopic cholecystectomy (LC) is mild. Postoperative pain can be reduced using a variety of pharmacologic and surgical analgesic approaches. For a single-center, one-surgeon randomized controlled trial, researchers sought to evaluate the effectiveness of combining operational analgesic methods with pharmaceutical analgesia in reducing pain in patients undergoing LC.

About 59 patients with LC appointments were split into 2 groups. Patients in the pharmacologic analgesia (P) group (n=29) received pharmacological treatment, including dexamethasone (8 mg), celecoxib (200 mg), and intraoperative acetaminophen (1 g). Patients were treated using both operative analgesic methods and pharmacologic analgesia in the operative analgesic treatments with pharmacologic analgesia (OP) group (n=30), which included low-pressure pneumoperitoneum, intraperitoneal normal saline irrigation, and aspiration of intraperitoneal carbon dioxide. At 0, 2, 6, and 24 hours following surgery, the area under the curve (AUC) of pain score for postoperative 24 h was evaluated. On the first postoperative day, the amount and quality of sleep were evaluated.

The OP group had reduced AUC/24 h pain levels at rest and on coughing (P<0.001 and P=0.001, respectively). At postoperative 2, 6, and 24 hours (P=0.001, P=0.001, and P=0.048, respectively), the pain ratings at rest were lower in the OP group. At postoperative 2 and 6 hours (P=0.004 and P=0.008, respectively), the pain ratings on cough were lower in the OP group. The need for analgesics was comparable. The OP group had a superior sleep quality score on the first postoperative day (56±18 vs. 67±15, absolute difference, 10; 95% CI, 2 to 19; P=0.017).

In contrast to pharmacologic analgesia used alone, combined operational analgesic therapy improved sleep quality and reduced pain levels in patients undergoing LC.

Reference: sciencedirect.com/science/article/pii/S1743919122005404