This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .
Effectiveness and Safety of Combined Epidural and General Anesthesia for Laparoscopic Cholecystectomy
Background and Objectives The aim of this study was to compare the efficacy and safety of two anesthesia techniques , combined epidural/general anesthesia ( CEGA ) versus total intravenous anesthesia ( TIVA ) , for laparoscopic cholecystectomy . Methods Forty patients were r and omly assigned to one of two different groups : group A received TIVA and group B received CEGA . At preset times during the operation , systolic and diastolic arterial pressure , heart rate , oxygen saturation ( SaO2 ) and end-tidal carbon dioxide ( Etco2 ) were monitored . Postoperatively , recovery ( Steward 's test ) and analgesia ( visual analog scale [ VAS ] pain scores ) were assessed , as well as the incidence of adverse effects . Results The groups were comparable as to demographic data and duration of surgery and of anesthesia . Intraoperative parameters also showed no statistical differences . Both groups had a rapid recovery ( Steward score of 6 within 12 minutes ) , but group B showed better recovery scores at 4 minutes . Postoperative pain was well controlled in both groups , but group B exhibited better scores at postoperative hour 2 . The incidence of postoperative side effects was low in both groups . Conclusions The use of CEGA for laparoscopic cholecystectomy seems to be effective and safe and to offer some advantages as compared to TIVA alone . CEGA can control pain due to CO2-induced peritoneal irritation , providing excellent intra- and postoperative analgesia . CEGA does not require the use of intraoperative intravenous opioids and shortens recovery time , without increasing the incidence of side effects
This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .