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 .
Emetic effects of morphine and piritramide.
BACKGROUND Successful management of postoperative pain requires that adequate analgesia is achieved without excessive adverse effects . Opioid-induced nausea and vomiting is known to impair patients ' satisfaction , but there are no studies providing sufficient power to test the hypothesis that the incidence of opioid-induced nausea and vomiting differs between micro -opioid receptor agonists . Thus , we tested the hypothesis that the incidence of vomiting and nausea differs between morphine and piritramide . METHODS In a prospect i ve , r and omized , double-blind fashion , we administered either morphine ( n=250 ) or piritramide ( n=250 ) by patient-controlled analgesia ( PCA ) for postoperative pain relief . We used a bolus dose of 1.5 mg with a lockout time of 10 min . Incidence and intensity ( numerical rating scale ) of postoperative nausea , vomiting , pain , patient satisfaction ( score 0 - 10 ) , side-effects ( score 0 - 3 ) and drug consumption were measured . RESULTS Mean drug consumption did not differ between the piritramide and morphine groups ( 30.8 ( SD 22.4 ) mg day(-1 ) vs 28.4 ( 21.8 ) mg day(-1 ) ) during the first postoperative day and there were no significant differences in the overall incidence of nausea ( 30 % vs 27 % ) and vomiting ( 19 % vs 15 % ) . Intensity of nausea correlated inversely ( P=0.01 ) with morphine consumption but not with piritramide consumption . Pain scores both at rest ( 2.2 ( 1.9 ) vs 2.6 ( 2 ) ) and during movement ( 4.4 ( 2.2 ) vs 4.9 ( 2.3 ) ) were slightly but significantly less with morphine . CONCLUSIONS Opioid-induced emesis was observed in about one-third of the patients using morphine  and  piritramide for PCA and the incidence of vomiting was one-half of that . Potential differences in the incidence of vomiting during PCA therapy between these micro-opioid receptor agonists can be excluded
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 .