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 .
Sympathetic suppression attenuates anomalous responses to morphine in unexplained pain after cholecystectomy
Anomalous responses to morphine are common in patients with unexplained pain in the upper abdomen after cholecystectomy and may be linked to activation of the sympathetic nervous system . The hypothesis that sympathetic suppression would attenuate anomalous responses to morphine was tested by a r and omized , cross-over trial using a st and ard challenge with morphine , with and without pretreatment with clonidine ( 300 µg orally , 1 h prior to the administration of morphine ) . In 13 of the 15 patients who completed the study , pre-treatment with clonidine decreased plasma concentrations of noradrenaline , dopamine and adrenaline by 56 , 15 and 25 % respectively . This was associated with a significant reduction in morphine-induced pain ( p = 0.02 ) and nausea ( p = 0.04 ) and attenuated increases in plasma aspartate aminotransferase ( AST ) activity ( p = 0.03 ) . Clonidine attenuates anomalous responses to morphine , perhaps through effects on sympathetic nervous activity or plasma concentrations of catecholamines
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 .