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 .
Pain after laparoscopic cholecystectomy
It is postulated that laparoscopic cholecystectomy as “ patient-friendly surgery ” leads to more comfort and in particular to less pain . A prospect i ve study on pain was performed on all patients undergoing the operation over the period of 1 year ( n=382 ) out of a series of more than 1,000 patients who have undergone the operation in our clinic .  Pain was measured by a 100-point visual analogue scale ( VAS ) , by a five-point verbal rating scale , and by the  consumption of analgesics . Pain was the most frequent symptom , both before and after the operation . The mean level of pain was 37 VAS points 5 h after the operation and declined to 16 points on the third day . In 106 patients ( 27.8 % ) the intensity of pain was higher than 50 VAS points . Analgesics  were used by 282 patients ( 73.8 % ) , opioids by 112 ( 29.3 % ) . Pain was significantly higher in female than male patients ( P<0.05 ) , but consumption of analgesics was similar in both groups . The most severe pain was localized to the abdominal wall wounds by 157 ( 41.1 % ) and to the right upper abdomen by 138 patients ( 36.1 % ) on the first postoperative day . Patients who needed  opioids  and /or had a pain level of > 50 VAS points ( n=138 ) had higher preoperative pain levels ( P=0.018 ) and preoperatively complained more frequently about nausea , vomiting , bloating , and a feeling of abdominal pressure ( P=0.003–0.031 ) . However , predictive values of these variables were too small to be of clinical benefit . The duration of operation , intraoperative events ( loss of bile , blood , or gallstones ) , and additional laparoscopic procedures ( adhesiolysis , lavage , extension of an incision , suture of fascia ) did not influence the intensity of postoperative pain . We conclude that laparoscopic cholecystectomy did cause significant postoperative pain in one-third of our patients only up to the first postoperative day . As predictors for high intensity of pain were not identified , pain should be monitored and analgesics should be delivered liberally
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 .