[Infusional therapy: an alternative for shouder pain post-laparoscopy]

Area of Science:

• Anesthesiology
• Pain Management
• Surgical Procedures

Background:

• Neuraxial anesthesia reduces complications in upper abdominal laparoscopic surgery.
• Shoulder pain is a frequent and challenging complication.
• Opioids for pain control can impair respiratory function.

Purpose of the Study:

• To compare different analgesic regimens for shoulder pain caused by pneumoperitoneum.
• To evaluate the efficacy and safety of multimodal analgesic strategies.

Main Methods:

• A nonrandomized clinical trial involving 56 patients undergoing laparoscopic cholecystectomy.
• Patients were divided into four groups receiving ketorolac, ketoprofen, or ketoprofen with varying doses of tramadol.
• Pain intensity, rescue analgesia, and operative time were analyzed.

Main Results:

• The ketorolac group experienced significantly more shoulder pain events.
• The group receiving ketoprofen 100 mg plus tramadol 100 mg required less rescue analgesia.
• No significant differences in operative time were noted between groups.

Conclusions:

• Preemptive infusional therapy with ketoprofen (100 mg) and tramadol (100 mg) is safe and effective for laparoscopic surgery.
• This multimodal approach provides superior shoulder pain control compared to other tested regimens.
• The ketoprofen-tramadol combination offers a viable alternative to opioids for managing post-operative pain.