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Duran MK, Öztürk Ş. The effect of shoulder massage on shoulder pain and sleep quality in patients after laparoscopic cholecystectomy: a randomized controlled trial. BMC Nurs 2024; 23:618. [PMID: 39232760 PMCID: PMC11373436 DOI: 10.1186/s12912-024-02264-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2024] [Accepted: 08/14/2024] [Indexed: 09/06/2024] Open
Abstract
BACKGROUND Laparoscopic cholecystectomy patients may suffer from sleep disturbances due to this postoperative pain. Postoperative pain and low sleep quality can lead to various unpredictable complications, including anxiety.The aim of this study is to determine the effect of shoulder massage administered to patients after laparoscopic cholecystectomy on pain and sleep quality. METHODS The study was designed as a randomized controlled trial.This study was carried out with 60 patients who underwent surgery at the General Surgery Department of a university's Faculty of Medicine between January 2020 and March 2021. The study was completed with 60 patients (30 in the intervention group and 30 in the control group). The patients in the intervention group received shoulder massage twice at 6-hour intervals. The data for the study were collected using the "Individual Introduction Form", the "VAS", and the "Richard Campbell Sleep Scale". RESULTS It was found that the pain of the patients in the intervention group significantly decreased compared to the control group 30 min after the massage (p˂0.05). However, 6 h after the massage, the pain levels in both groups were similar. The sleep quality of the patients in the intervention group was significantly higher compared to those in the control group (p˂0.05). CONCLUSIONS It was determined that the massage therapy yielded a short-term alleviation of shoulder pain among the patients while also enhancing their sleep quality. These results suggest that shoulder massage could be effectively incorporated into nursing practice as a means to ameliorate pain levels and enhance sleep quality in postoperative patients. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT06480149 (retrospectively registered, Protocol ID: 2019/06-8Last Update Posted 2024-06-28) https://ctv.veeva.com/study/shoulder-massage-after-cholecystectomy .
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Affiliation(s)
| | - Şenay Öztürk
- School of Nursing, Maltepe University, Istanbul, Turkey.
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Cao L, Yang T, Hou Y, Yong S, Zhou N. Efficacy and Safety of Different Preemptive Analgesia Measures in Pain Management after Laparoscopic Cholecystectomy: A Systematic Review and Network Meta-Analysis of Randomized Controlled Trials. Pain Ther 2024:10.1007/s40122-024-00647-w. [PMID: 39227523 DOI: 10.1007/s40122-024-00647-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2024] [Accepted: 08/15/2024] [Indexed: 09/05/2024] Open
Abstract
INTRODUCTION The purpose of this systematic review and network meta-analysis was to evaluate the efficacy and safety of different preemptive analgesia measures given before laparoscopic cholecystectomy (LC) for postoperative pain in patients. METHODS We conducted a comprehensive search in databases including PubMed, Web of Science, Embase, and the Cochrane Library up to March 2024, and collected relevant research data on the 26 preemptive analgesia measures defined in this article in LC surgery. Outcomes included postoperative Visual Analogue Scores (VAS) at different times (2, 6, 12, and 24 h), opioid consumption within 24 h post-operation, time to first rescue analgesia, incidence of postoperative nausea and vomiting (PONV), and incidence of postoperative headache or dizziness. RESULTS Forty-nine articles involving 5987 patients were included. The network meta-analysis revealed that multimodal analgesia, nerve blocks, pregabalin, and gabapentin significantly reduced postoperative pain scores at all postoperative time points and postoperative opioid consumption compared to placebo. Tramadol, pregabalin, and gabapentin significantly extended the time to first rescue analgesia. Ibuprofen was the best intervention for reducing PONV incidence. Tramadol significantly reduced the incidence of postoperative headache or dizziness. Subgroup analysis of different doses of pregabalin and gabapentin showed that compared to placebo, pregabalin (300 mg, 150 mg) and gabapentin (600 mg, 300 mg, and 20 mg/kg) were all more effective without significant differences in efficacy between these doses. Higher doses increased the incidence of PONV and postoperative headache and dizziness, with gabapentin 300 mg having a lower adverse drug reaction (ADR) incidence. CONCLUSIONS Preemptive analgesia significantly reduced postoperative pain intensity, opioid consumption, extended the time to first rescue analgesia, and decreased the incidence of PONV and postoperative headache and dizziness. Multimodal analgesia, nerve blocks, pregabalin, and gabapentin all showed good efficacy. Gabapentin 300 mg given preoperatively significantly reduced postoperative pain and ADR incidence, recommended for preemptive analgesia in LC. TRIAL REGISTRATION PROSPERO CRD42024522185.
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Affiliation(s)
- Lu Cao
- Department of Pharmacy, Shaanxi Provincial People's Hospital, Youyixi Road, Beilin District, Xi'an, Shaanxi, China
| | - Tongfei Yang
- Department of Pharmacy, Shaanxi Provincial People's Hospital, Youyixi Road, Beilin District, Xi'an, Shaanxi, China
| | - Yajing Hou
- Department of Pharmacy, Shaanxi Provincial People's Hospital, Youyixi Road, Beilin District, Xi'an, Shaanxi, China
| | - Suyun Yong
- Department of Pharmacy, Shaanxi Provincial People's Hospital, Youyixi Road, Beilin District, Xi'an, Shaanxi, China.
| | - Nan Zhou
- Department of Pharmacy, Shaanxi Provincial People's Hospital, Youyixi Road, Beilin District, Xi'an, Shaanxi, China
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Bourgeois C, Oyaert L, Van de Velde M, Pogatzki-Zahn E, Freys SM, Sauter AR, Joshi GP, Dewinter G. Pain management after laparoscopic cholecystectomy: A systematic review and procedure-specific postoperative pain management (PROSPECT) recommendations. Eur J Anaesthesiol 2024:00003643-990000000-00210. [PMID: 39129451 DOI: 10.1097/eja.0000000000002047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/13/2024]
Abstract
Laparoscopic cholecystectomy can be associated with significant postoperative pain that is difficult to treat. We aimed to evaluate the available literature and develop updated recommendations for optimal pain management after laparoscopic cholecystectomy. A systematic review was performed using the procedure-specific postoperative pain management (PROSPECT) methodology. Randomised controlled trials and systematic reviews published in the English language from August 2017 to December 2022 assessing postoperative pain after laparoscopic cholecystectomy using analgesic, anaesthetic or surgical interventions were identified from MEDLINE, Embase and Cochrane Databases. From 589 full text articles, 157 randomised controlled trials and 31 systematic reviews met the inclusion criteria. Paracetamol combined with NSAIDs or cyclo-oxygenase-2 inhibitors should be given either pre-operatively or intra-operatively, unless contraindicated. In addition, intra-operative intravenous (i.v.) dexamethasone, port-site wound infiltration or intraperitoneal local anaesthetic instillation are recommended, with opioids used for rescue analgesia. As a second-line regional technique, the erector spinae plane block or transversus abdominis plane block may be reserved for patients with a heightened risk of postoperative pain. Three-port laparoscopy, a low-pressure pneumoperitoneum, umbilical port extraction, active aspiration of the pneumoperitoneum and saline irrigation are recommended technical aspects of the operative procedure. The following interventions are not recommended due to limited or no evidence on improved pain scores: single port or mini-port techniques, routine drainage, low flow insufflation, natural orifice transluminal endoscopic surgery (NOTES), infra-umbilical incision, i.v. clonidine, nefopam and regional techniques such as quadratus lumborum block or rectus sheath block. Several interventions provided better pain scores but are not recommended due to risk of side effects: spinal or epidural anaesthesia, gabapentinoids, i.v. lidocaine, i.v. ketamine and i.v. dexmedetomidine.
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Affiliation(s)
- Camille Bourgeois
- From the Department of Cardiovascular Sciences, Section Anaesthesiology, KU Leuven and University Hospital Leuven, Belgium (CB, LO, MvdV, GD), Department of Anaesthesiology, Intensive Care, and Pain Medicine, University Hospital Münster, Münster (EP-Z), Department of Surgery, DIAKO Ev. Diakonie-Krankenhaus, Bremen, Germany (SMF), Division of Emergencies and Critical Care, Department of Anaesthesiology and Department of Research and Development, Oslo University Hospital, Oslo, Norway (ARS), Department of Anaesthesiology and Pain Management, University of Texas Southwestern Medical Center, Dallas, Texas, USA (GPJ)
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Behroozi Z, Jafarpour M, Razmgir M, Saffarpour S, Azizi H, Kheirandish A, Kosari-Rad T, Ramezni F, Janzadeh A. The effect of gabapentin and pregabalin administration on memory in clinical and preclinical studies: a meta-analysis and systematic review. BMC Psychiatry 2023; 23:262. [PMID: 37069609 PMCID: PMC10111701 DOI: 10.1186/s12888-023-04696-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Accepted: 03/20/2023] [Indexed: 04/19/2023] Open
Abstract
BACKGROUND Today, gabapentinoids such as Gabapentin (GBP) and pregabalin (PGB) are widely used as painkillers. This may alter the function of the nervous system; hence their results may include a difference in memory and processes that end in memory formation. This study aims to conclude whether gabapentinoids can alter memory or not by reviewing and analyzing clinical and preclinical studies. MATERIAL AND METHODS A comprehensive search was carried out in databases including PUBMED, EMBASE, SCOPUS, and Web of Science. In the included studies, memory was measured as an outcome variable in clinical or preclinical studies. RESULT A total of 21 articles (4 clinical, 17 preclinical) were included in the meta-analysis by STATA Software. The results showed that memory changes under the influence of GBP. Both the administrated dosage and the time of administration are important in the final results and latency time of retention. GBP administration in healthy animals increased latency time, whereas if the administration of GBP took place exactly before training, the latency time increased slightly. Short-term administration of PGB in healthy volunteers is accompanied by transient side effects on the CNS. However, the number and homogeneity of the studies were not such that a meta-analysis could be performed on them. CONCLUSION Clinical and preclinical studies showed that PGB administration did not confirm its improving memory effect. GBP administration in healthy animals increased latency time and improved memory. Although it depended on the time of administration.
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Affiliation(s)
- Zahra Behroozi
- Physiology Research Center, Institute of Neuropharmacology, Kerman University of Medical Sciences, Kerman, Iran
| | - Maral Jafarpour
- The International Campus of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Maryam Razmgir
- Department of Medical Library and Information Sciences, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran
| | - Sepideh Saffarpour
- Department of Microbiology, Shahr-E-Qods Branch, Islamic Azad University, Tehran, Iran
| | - Hanieh Azizi
- Medical University of Pécs Hungary, Pécs, Hungary
- BG Unfall Klinik, Frankfurt, Germany
| | - Ali Kheirandish
- Department of Pharmacology, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran
| | - Tahereh Kosari-Rad
- Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Ramezni
- Physiology Research Center, Iran University of Medical Sciences, Tehran, Iran.
| | - Atousa Janzadeh
- Radiation Biology Research Center, Iran University of Medical Sciences, Tehran, Iran.
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Tubog TD, Harmer CM, Bramble RS, Bayaua NE, Mijares M. Efficacy and Safety of Gabapentin on Postoperative Pain Management After Bariatric Surgery: A Systematic Review and Meta-Analysis. J Perianesth Nurs 2023; 38:322-330. [PMID: 36414492 DOI: 10.1016/j.jopan.2022.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/25/2022] [Accepted: 04/30/2022] [Indexed: 11/21/2022]
Abstract
PURPOSE Examine the efficacy and safety of perioperative gabapentin in bariatric surgical patients. DESIGN Systematic Review and Meta-analysis. METHODS An exhaustive search was conducted using PubMed, Cochrane Library, MEDLINE, CINAHL, Google Scholar, and other gray literature. Only randomized controlled trials evaluating the use of gabapentin in bariatric surgery were included. Risk ratio (RR) and mean difference (MD) were used to estimate outcomes with suitable effect models. Quality of evidence was assessed using the Risk of Bias and GRADE system. FINDINGS Four trials consisting of 283 patients were analyzed. The use of gabapentin significantly lowered the cumulative pain score in the first 24 hours after surgery by an average of 1.04 (MD, -1.04; 95% CI, -1.45 to -0.63; P < .00001). Gabapentin also reduced the overall morphine equivalent consumption by 7.89 mg (MD, -7.89; 95% CI, -13.56 to -2.2; P = .006). However, gabapentin did not affect the incidence of PONV (RR, 0.61; 95% CI, 0.38-1.00; P = .05), somnolence (RR, 1.25; 95% CI, 0.57-2.73; P = .57), dizziness (RR, 1.01; 95% CI, 0.40-2.54; P = .99), and headache (RR, 0.76; 95% CI, 0.25-2.30; P = .62). Substantial heterogeneity, imprecision of the effect size, and potential publication bias were limitations of this review. CONCLUSIONS The use of gabapentin is effective in the management of postoperative pain in bariatric surgery. However, there is limited data regarding the opioid-sparing effect and adverse effect profiles of gabapentin in the bariatric surgical population.
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Affiliation(s)
- Tito D Tubog
- Graduate Programs of Nurse Anesthesia, Texas Wesleyan University, Fort Worth, TX.
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Sane S, Sayyadi S, Abbasivash R, Rezaei S, Azadfar A, Salimi S. Comparison of the Effect of Preoperative Oral Tizanidine and Pregabalin on Shoulder Pain in Laparoscopic Cholecystectomy Under General Anesthesia. Adv Biomed Res 2023; 12:58. [PMID: 37200747 PMCID: PMC10186033 DOI: 10.4103/abr.abr_222_22] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/13/2022] [Accepted: 09/13/2022] [Indexed: 05/20/2023] Open
Abstract
Background Shoulder pain is considered as the most important and relatively common postoperative cholecystectomy complications that often controls in recovery room by systemic narcotics that may have some side effects. The aim of this study was to evaluate the effect of premedication with oral tizanidine on shoulder pain relief after elective laparoscopic cholecystectomy. Materials and Methods In this double-blinded clinical trial, 75 adults of American Society of Anesthesiologist physiologic state 1 and 2 scheduled for elective laparoscopic cholecystectomy under general anesthesia were selected and randomly divided in three groups of T, P, and control groups. Ninety minutes before the induction of anesthesia, patients received either 4 mg tizanidine (T group), 100 mg pregabalin (P group), or orally in 50cc or the same volume of plain water as a placebo (control group). Then, the vital signs, pain intensity, and the need for analgesic were measured during 24 hours and then compared in the groups. Results There was no significant difference in patient characteristics, with respect to age, weight, gender, and duration of anesthesia and surgery between the groups (P > 0.05). The pain intensity and need for analgesic were significantly lower in tizanidine and pregabalin groups than the control group (P < 0.003) vs (P < 0.001). There was no significant difference in vital signs characteristics between the groups. Conclusion Oral administration of 4 mg tizanidine and 100 mg pregabalin 90 minutes before laparoscopic cholecystectomy significantly relive postoperative shoulder pain and analgesic consumption without any complication.
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Affiliation(s)
- Shahryar Sane
- Department of Anesthesiology, School of Medicine, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Shahram Sayyadi
- Department of Anesthesiology, School of Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Rahman Abbasivash
- Department of Anesthesiology, School of Medicine, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Seyfollah Rezaei
- Department of General Surgery, School of Medicine, Imam Khomeini Hospital, Urmia University of Medical Sciences, Urmia, Iran
| | - Ashkan Azadfar
- Department of Anesthesiology, School of Medicine, Urmia University of Medical Sciences, Urmia, Iran
| | - Sohrab Salimi
- Department of Anesthesiology, School of Medicine, Anesthesiology Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
- Address for correspondence: Dr. Sohrab Salimi, Department of Anesthesiology, School of Medicine, Anesthesiology Research Center, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. E-mail:
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Williams CD, Al-Jammali Z, Herink MC. Gabapentinoids for Pain: A Review of Published Comparative Effectiveness Trials and Data Submitted to the FDA for Approval. Drugs 2023; 83:37-53. [PMID: 36529848 DOI: 10.1007/s40265-022-01810-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2022] [Indexed: 12/23/2022]
Abstract
Use of the gabapentinoids for pain continues to increase. In 2018, the US Food and Drug Administration (FDA) strengthened the warnings for both gabapentin and pregabalin to emphasize the central nervous system side effects and the risk of respiratory depression, especially when combined with other centrally acting drugs. We reviewed the published comparative effectiveness literature for gabapentinoids for pain as well as all trials (published and unpublished) used by the FDA for the approval of the five pain indications for these agents (one for gabapentin, four for pregabalin). Among the findings of interest are the fact that the FDA rejected the application for gabapentin for diabetic peripheral neuropathy based on the risk versus benefit profile of that drug in the clinical trials that were submitted by the manufacturer. Additionally, both the comparative effectiveness trials as well as the studies used by the FDA tend to be short in duration and show only modest pain benefits for the gabapentinoids. The placebo response in these trials was frequently one-third to one-half as great as the pain benefit demonstrated by the gabapentinoid. Based on the available clinical trial evidence, we feel prescribers should be cautious when using gabapentinoids for pain, particularly when using these agents for a prolonged period or when combined with other, centrally acting agents.
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Affiliation(s)
- C D Williams
- Oregon State University College of Pharmacy, 2730 SW Moody Ave., CL5CP, Portland, OR, USA.
| | - Z Al-Jammali
- Oregon State University College of Pharmacy, 2730 SW Moody Ave., CL5CP, Portland, OR, USA
| | - M C Herink
- Oregon State University College of Pharmacy, 2730 SW Moody Ave., CL5CP, Portland, OR, USA
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Jiang Y, Wu Y, Lu S, Que Y, Chi Y, Liu Q. Patients with low body mass index are more likely to develop shoulder pain after laparoscopy. Acta Obstet Gynecol Scand 2022; 102:99-104. [PMID: 36324236 PMCID: PMC9780717 DOI: 10.1111/aogs.14477] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2022] [Revised: 09/26/2022] [Accepted: 10/18/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Shoulder pain is one of the most common complications after laparoscopy. Previous studies have found a number of methods to reduce shoulder pain after laparoscopic surgery, but these methods have not been targeted to specific populations. The purpose of this study was to identify people who are more likely to develop shoulder pain. MATERIAL AND METHODS A total of 203 patients underwent laparoscopy for benign gynecological diseases between July 2020 and February 2021. Patients were divided into two groups according to the Chinese overweight standard, body mass index less than 24 kg/m2 group and 24 kg/m2 or more group. The baseline characteristics and intraoperative data between the two groups were compared. The intensity of the shoulder pain was quantified using a visual analog scale (VAS). RESULTS The incidence and the VAS scores of shoulder pain were significantly higher in the less than 24 kg/m2 group (63.64% vs 38.03%, p < 0.001 in incidence; median 5 (interquartile range [IQR] 3-7) vs 3 (IQR 2-5), p < 0.001 in VAS scores), and the chance of shoulder pain within 24 hours after laparoscopy was higher in the less than 24 kg/m2 group (89.29% vs 66.67%, p = 0.013). In univariate and multivariate logistic regression analysis, BMI less than 24 kg/m2 was an independent risk factor of shoulder pain after laparoscopic surgery (p = 0.001, p = 0.031, respectively). Shoulder pain scores were inversely correlated with BMI (r = -0.300, p = 0.001). CONCLUSIONS Patients with low body mass index are more likely to develop shoulder pain after laparoscopy, with earlier onset and higher pain scores.
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Affiliation(s)
- Yuxia Jiang
- Department of GynecologyPeople's Hospital of Shapingba DistrictChongqingChina
| | - Yijun Wu
- Department of GynecologyPeople's Hospital of Shapingba DistrictChongqingChina
| | - Shentao Lu
- Department of Obstetrics and GynecologyChongqing Health Center for Women and Children (Women and Children's Hospital of Chongqing Medical University)ChongqingChina
| | - Yuni Que
- Department of GynecologyPeople's Hospital of Shapingba DistrictChongqingChina
| | - Yugang Chi
- Department of Obstetrics and GynecologyChongqing Health Center for Women and Children (Women and Children's Hospital of Chongqing Medical University)ChongqingChina
| | - Qianfen Liu
- Department of Obstetrics and GynecologyChongqing Health Center for Women and Children (Women and Children's Hospital of Chongqing Medical University)ChongqingChina
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Kumar AH, Habib AS. The role of gabapentinoids in acute and chronic pain after surgery. Curr Opin Anaesthesiol 2019; 32:629-634. [DOI: 10.1097/aco.0000000000000767] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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The Impact of Parecoxib on Pain Management for Laparoscopic Cholecystectomy: A Meta-analysis of Randomized Controlled Trials. Surg Laparosc Endosc Percutan Tech 2019; 29:69-74. [DOI: 10.1097/sle.0000000000000626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Qiu J, Xie M, Qu R. The Influence of Etoricoxib on Pain Control for Laparoscopic Cholecystectomy: A Meta-analysis of Randomized Controlled Trials. Surg Laparosc Endosc Percutan Tech 2019; 29:150-154. [PMID: 30855399 DOI: 10.1097/sle.0000000000000635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION The efficacy of etoricoxib on pain control for laparoscopic cholecystectomy remains controversial. We conduct a systematic review and meta-analysis to explore the impact of etoricoxib on pain intensity after laparoscopic cholecystectomy. MATERIALS AND METHODS We searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2018 for randomized controlled trials assessing the effect of etoricoxib versus placebo on pain management after laparoscopic cholecystectomy. This meta-analysis was performed using the random-effect model. RESULTS Four randomized controlled trials involving 351 patients are included in the meta-analysis. Overall, compared with control group for laparoscopic cholecystectomy, etoricoxib has no important impact on pain scores within 4 hours [mean difference (MD)=-1.48; 95% confidence interval (CI)=-3.54 to 0.58; P=0.16] and 8 hours (MD=-0.65; 95% CI=-1.43 to 0.12; P=0.10), but can significantly decrease pain intensity within 12 hours (MD=-1.16; 95% CI=-1.93 to -0.38; P=0.003) and 24 hours (MD=-1.10; 95% CI=-1.98 to -0.22; P=0.01), as well as postoperative analgesic consumption (standard MD=-1.21; 95% CI=-2.19 to -0.23; P=0.02), with no increase in nausea and vomiting (risk ratio=0.68; 95% CI=0.42-1.10; P=0.11), and headache (risk ratio=0.96; 95% CI=0.44-2.09; P=0.92). CONCLUSIONS Etoricoxib can substantially reduce pain intensity in patients with laparoscopic cholecystectomy.
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Affiliation(s)
- Jin Qiu
- Departments of Aneshesiology
| | | | - Ronglan Qu
- ICU, ChongQing Traditional Chinese Medicine Hospital, Jiangbei District, Chongqing, China
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Gabriel RA, Swisher MW, Sztain JF, Furnish TJ, Ilfeld BM, Said ET. State of the art opioid-sparing strategies for post-operative pain in adult surgical patients. Expert Opin Pharmacother 2019; 20:949-961. [DOI: 10.1080/14656566.2019.1583743] [Citation(s) in RCA: 42] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Affiliation(s)
- Rodney A. Gabriel
- Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain, University of California, San Diego, La Jolla, CA, USA
- Division of Biomedical Informatics, University of California, San Diego, La Jolla, CA, USA
- Outcomes Research Consortium, Cleveland, OH, USA
| | - Matthew W. Swisher
- Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain, University of California, San Diego, La Jolla, CA, USA
- Outcomes Research Consortium, Cleveland, OH, USA
| | - Jacklynn F. Sztain
- Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain, University of California, San Diego, La Jolla, CA, USA
| | - Timothy J. Furnish
- Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain, University of California, San Diego, La Jolla, CA, USA
| | - Brian M. Ilfeld
- Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain, University of California, San Diego, La Jolla, CA, USA
- Outcomes Research Consortium, Cleveland, OH, USA
| | - Engy T. Said
- Department of Anesthesiology, Division of Regional Anesthesia and Acute Pain, University of California, San Diego, La Jolla, CA, USA
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