Abdelhedi Ahmed, Ketata Salma, Kardoun Nizar, Keskes Mariem, Zouche Imen, Ayedi Amal, Doukeli Oussema, Khrouf Mariem, Fendri Sami, Zouari Amine, Cheikhrouhou Hichem
Service d'Anesthésie Réanimation Chirurgicale, Centre Hospitalier Universitaire Habib Bourguiba Sfax, Sfax, Tunisie.
Service de Chirurgie Viscérale, Centre Hospitalier Universitaire Habib Bourguiba Sfax, Sfax, Tunisie.
Pan Afr Med J. 2023 May 4;45:14. doi: 10.11604/pamj.2023.45.14.36438. eCollection 2023.
the effect of intravenous corticosteroids on postoperative pain has been well demonstrated; however, few studies have focused on the efficacy of intraperitoneal corticosteroid use after laparoscopic surgery. The purpose of this study was to evaluate the effect of intraperitoneal administration of dexamethasone on postoperative analgesia after laparoscopic cholecystectomy.
we conducted a prospective, randomised, double-blind, controlled study, including patients scheduled for laparoscopic cholecystectomy and randomised into two groups: the group D (receiving 16 ml: 12 ml saline and 4 ml solution containing 16mg dexamethasone) and the group T (receiving 16 ml saline). The primary endpoint was: Visual Analogue Scale (VAS) for abdominal pain during the first 24 hours after surgery. The secondary endpoints were the incidence of shoulder pain, time to first request for analgesia, the consumption of morphine in the post-intervention surveillance room (PACU), the consumption of non-opioid analgesics and the incidence of nausea and vomiting during the first 24 hours after surgery as well as the presence of complications.
sixty patients were included in the study and divided into two groups of 30. Demographic parameters, duration of surgical and anesthesia procedures, as well as intraoperative fentanyl consumption were comparable between the two groups. Abdominal pain VAS values (p≤0.001), the incidence of shoulder pain (p<0.001), opioid and analgesic consumption (p<0.001) and the incidence of nausea (p=0.002) and vomiting (p=0.012) during the first 24 hours after surgery were significantly lower in group D. No complications related to dexamethasone administration were noted.
intraperitoneal dexamethasone reduces postoperative pain after laparoscopic cholecystectomy.
静脉注射皮质类固醇对术后疼痛的影响已得到充分证实；然而，很少有研究关注腹腔镜手术后腹腔内使用皮质类固醇的疗效。本研究的目的是评估腹腔内注射地塞米松对腹腔镜胆囊切除术后镇痛的效果。
我们进行了一项前瞻性、随机、双盲、对照研究，纳入计划进行腹腔镜胆囊切除术的患者，并随机分为两组：D组（接受16毫升：12毫升生理盐水和4毫升含16毫克地塞米松的溶液）和T组（接受16毫升生理盐水）。主要终点是：术后24小时内腹部疼痛的视觉模拟评分（VAS）。次要终点包括肩部疼痛的发生率、首次要求镇痛的时间、干预后监测室（PACU）内吗啡的消耗量、非阿片类镇痛药的消耗量、术后24小时内恶心和呕吐的发生率以及并发症的发生情况。
60名患者纳入研究并分为两组，每组30人。两组的人口统计学参数、手术和麻醉程序持续时间以及术中芬太尼消耗量具有可比性。术后24小时内，D组的腹部疼痛VAS值（p≤0.001）、肩部疼痛发生率（p<0.001）、阿片类药物和镇痛药消耗量（p<0.001）以及恶心（p=0.002）和呕吐（p=0.012）发生率均显著较低。未观察到与地塞米松给药相关的并发症。
腹腔内地塞米松可减轻腹腔镜胆囊切除术后的疼痛。
