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 .
Suprascapular nerve block or a piroxicam patch for shoulder tip pain after day case laparoscopic surgery
Background and objective : The reported incidence of shoulder tip pain following laparoscopic surgery varies from 35 to 63 % . This study evaluated the analgesic efficacy of either performing a prophylactic suprascapular nerve block with bupivacaine or applying a piroxicam patch to the skin over both shoulders for the relief of shoulder tip pain after laparoscopy . Methods : Sixty healthy informed female patients were r and omly assigned to one of three groups : ( a ) a control group ( n = 20 ) , no treatment ; ( b ) a suprascapular nerve block group ( n = 20 ) in which a bilateral suprascapular nerve block was performed before induction of anaesthesia with 5 mL 0.5 % bupivacaine with epinephrine ; and ( c ) a piroxicam patch group ( n = 20 ) in which a 48 mg piroxicam patch on the skin of each shoulder was applied before induction of anaesthesia . All patients received a total intravenous anaesthesia technique with propofol , fentanyl and vecuronium .  Shoulder tip and wound pain were recorded on a visual analogue pain scale at five time intervals for 24 h after surgery . Results : A total of 80 % of patients in the control group , 75 % in the suprascapular nerve block group and 45 % in the piroxicam patch group complained of shoulder tip pain during the recording period ( P < 0.05 ) . The scores for shoulder tip pain in the piroxicam patch group were significantly lower compared with the control group at 3 , 6 and 12 h , and compared with the suprascapular nerve block group at 6 and 12 h. The need for analgesics was also significantly lower in the piroxicam patch group compared with the other two groups . Conclusions : Prophylactic piroxicam patches are effective and safe for the relief of shoulder tip pain after laparoscopy . Bilateral suprascapular nerve block is not effective in this setting
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 .