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 .
Postoperative pain treatment after cholecystectomy with epidural sufentanil at lumbar or thoracic level.
The difference in analgesic activity following lumbar ( group I ) or thoracic ( group II ) epidural administration of 50 micrograms sufentanil was studied after cholecystectomy . Fifteen patients in each group were evaluated for pain relief using a linear analog scale ( LAS ) , heart rate ( HR ) , mean arterial pressure ( MAP ) , respiratory rate ( RR ) , peak expiratory flow ( PEF ) , forced vital capacity ( FVC ) , forced expiratory volume ( FEV1 ) and arterial CO2 tension ( PaCO2 ) . In five additional patients in each group 75 micrograms sufentanil was injected for determination of serum levels . Pain scores were lower than three in both groups after 10 min , while mean pain scores remained below one from 20 min until 2 h following injection in both groups . Satisfactory pain relief lasted for 4 h. RR was significantly decreased from two until 360 min . in the lumbar group and from five until 120 min in the thoracic group . PaCO2 was raised in both groups only during the first hour . PEF and FVC were significantly improved compared to control 1 , 2 and 4 h following injection . Serum sufentanil levels reached a maximum of 0.299 + /- 0.052 ng.ml-1 in the lumbar group and 0.377 + /- 0.076 ng.ml-1 in the thoracic group after 5 min . There were no significant differences between the two groups in the variables studied
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 .