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 .
Prospective randomized blinded trial of pulmonary function, pain, and cosmetic results after laparoscopic vs microlaparoscopic cholecystectomy
Abstract Background : The size of laparoscopic instruments has been reduced for use in abdominal video endoscopic surgery . However , it has yet to be proven that microlaparoscopic surgery will actually result in clinical ly relevant benefits for patients . Methods : Fifty patients were r and omized in a blinded fashion to receive either elective laparoscopic ( MINI ) , ( n= 25 ) or microlaparoscopic ( MICRO ) ( n= 25 ) cholecystectomy .  Pulmonary function ( FVC , FEV 1 ) , analgesic consumption during patient-controlled analgesia ( PCA ) , pain perception by visual analogue score ( VAS ) , and the cosmetic result ( by the patient 's self- assessment ) were evaluated postoperatively as clinical ly relevant end points . Results : Age , sex , body mass index ( BMI ) , preoperative pulmonary function , pain perception , and operative time were similar for the two groups . At 8:00 PM on the day of surgery , FVC ( MINI : 1.96 L [ range , 1.48–2.48 ] ; MICRO : 2.13 L ) [ ( range , 1.61.–2.50 ) ] and FEV 1 ( MINI : 1.17 L/sec ) [ range , 0.87–1.48 ] ; MICRO : 1.34 L/sec [ range , 1.05.–2.14 ] were also similar ( each p= 0.5 ) . From surgery to the 3rd postoperative day , cumulative PCA morphine doses were comparable ( MINI : 0.15 mg/kg bw [ range , 0.09–0.23 ] ; MICRO : 0.21 mg/kg bw [ range , 0.10–0.42 ] ; p= 0.4 ) , but overall VAS scores for pain while coughing were higher in the laparoscopic group ( 406 [ range , 358–514 ] ) than in the microlaparoscopic group ( 365 [ range , 215–427 ] ; p= 0.02 ) . The cosmetic result was judged to be slightly superior by the microlaparoscopic patients ( 10 [ range , 9–10 ] ) , as compared to those in the laparoscopic ( 9 [ range , 8–10 ] ) group ( p= 0.04 ) . Conclusion : Because microlaparoscopic cholecystectomy has some minor advantages over laparoscopic surgery , it should be considered for use in selected patients
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 .