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 .
Preoperative Dexamethasone Improves Surgical Outcome After Laparoscopic Cholecystectomy: A Randomized Double-Blind Placebo-Controlled Trial
Objective : To determine the effects of preoperative dexamethasone on surgical outcome after laparoscopic cholecystectomy ( LC ) . Summary Background Data : Pain and fatigue are dominating symptoms after LC and may prolong convalescence . Methods : In a double-blind , placebo-controlled study , 88 patients were r and omized to intravenous dexamethasone ( 8  mg ) or placebo  90 minutes before LC . Patients received a similar st and ardized anesthetic , surgical , and multimodal analgesic treatment . All patients were recommended 2 days postoperative duration of convalescence . The primary endpoints were fatigue and pain . Preoperatively and at several times during the first 24 postoperative hours , we measured C-reactive protein ( CRP ) and pulmonary function , pain scores , nausea , and number of vomiting episodes were registered . Analgesic and antiemetic requirements were recorded . Also , on a daily basis , patients reported scores of fatigue and pain before and during the first postoperative week and the date s for resumption of work and recreational activities . Results : Eight patients were excluded from the study , leaving 40 patients in each study group for analysis . There were no apparent side effects of the study drug . Dexamethasone significantly reduced postoperative levels of CRP ( P = 0.01 ) , fatigue ( P = 0.01 ) , overall pain , and incisional pain during the first 24 postoperative hours ( P < 0.05 ) and total requirements of opioids ( P < 0.05 ) . In addition , cumulated overall and visceral pain scores during the first postoperative week were significantly reduced ( P < 0.05 ) . Dexamethasone also reduced nausea and vomiting on the day of operation ( P < 0.05 ) . Resumption of recreational activities was significantly faster in the dexamethasone group versus placebo group ( median 1 day versus 2 days ) ( P < 0.05 ) . Conclusion : Preoperative dexamethasone ( 8 mg ) reduced pain , fatigue , nausea and vomiting , and duration of convalescence in patients undergoing noncomplicated LC , when compared with placebo , and is recommended for routine use
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 .