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 .
A Single Small Dose of Postoperative Ketamine Provides Rapid and Sustained Improvement in Morphine Analgesia in the Presence of Morphine-Resistant Pain
It is a common clinical observation that  postoperative  pain may be resistant to morphine . The analgesic potentials of ketamine have also been well documented . In this study , we evaluated the effects of postoperative coadministration of small doses of ketamine and morphine on pain intensity , Spo2 , and subjectively rated variables in surgical patients who underwent st and ardized general anesthesia and complained of pain ( ≥6 of 10 on a visual analog scale [ VAS ] ) despite > 0.1 mg/kg of IV morphine administration within 30 min . Patients r and omly received up to three boluses of 30 & mgr;g/kg of morphine plus saline ( MS;n = 114 ) or 15 & mgr;g/kg of morphine plus 250 & mgr;g/kg of ketamine ( MK;n = 131 ) within 10 min in a double-blinded manner . The MS group ’s pain VAS scores were 5.5 ± 1.18 and 3.8 ± 0.9 after 10 and 120 min , respectively , after 2.52 ± 0.56 injections , versus the MK group ’s VAS scores of 2.94 ± 1.28 and 1.47 ± 0.65 , respectively ( P < 0.001 ) , after 1.35 ± 0.56 injections ( P < 0.001 ) . The 10-min level of wakefulness ( 1–10 VAS ) in the MS group was significantly ( P < 0.001 ) less ( 6.1 ± 1.5 ) than the MK group ’s ( 8.37 ± 1.19 ) . Spo2 decreased by 0.26 % in the MS group but increased by 1.71 % in the MK patients at the 10-min time point ( P < 0.001 ) . Thirty MS versus nine MK patients ( P < 0.001 ) experienced nausea/vomiting ; nine MK patients sustained a 2-min light-headed sensation , and one patient had a weird dream after the second drug injection
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 .