Surgicel® fibrillar as an innovative analgesic reservoir for post-laparoscopic cholecystectomy pain management: Randomized double-blind trial | ||||
| Egyptian Journal of Anaesthesia | ||||
| Volume 38, Issue 1, December 2022, Page 542-549 PDF (1.23 MB) | ||||
| DOI: TEJA-2022-0125 | ||||
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| Authors | ||||
| Esam Hamed; Ragaa Herdan; Ahmed M. Taha; Abdullah AlHaddad; Mohamed F. Mostafa | ||||
| Abstract | ||||
| Background Strong analgesia is still needed after laparoscopic cholecystectomy (LC). Surgicel® is a haemostatic agent, capable of absorbing fluids several times its volume, although pain is lower than after open surgeries. We hypothesized that Surgicel® could function as an innovative carrier for sustained-release postoperative analgesia. Methods Ninety patients (18–65 years) scheduled for LC were randomized to receive a mixture of 20 ml bupivacaine 0.5%, 10 ml lidocaine 2%, epinephrine 5 µg/ml, and morphine 0.1 mg/kg instilled at hepatic fossa, trocar sites, and under the right copula of the diaphragm (Group-I). Group-II received similar mixture to soak Surgicel® applied at the hepatic fossa and trocar sites. Group-III received normal saline to soak Surgicel® at the same locations. Visual analog scale at 1, 2, 4, 6, 12, and 24 h postoperatively was the primary outcome, while the secondary outcomes included Verbal rating scale, time to first rescue analgesia, total 24-h analgesia, time for the return of bowel function, patients’ satisfaction, and adverse effects. Results Group-II showed the lowest pain scores ( > 0.05), the longest time before requesting analgesia ( = 0.004), used least extra analgesia ( ≤ 0.001), maintained highest satisfaction scores ( ≤ 0.001), and lowest complications ( = 0.048). Group-I showed better results regarding pain control compared to group-III after 2 h ( = 0.02) with prolonged time to first analgesia ( < 0.001) and less analgesic consumption ( < 0.001). Conclusion Application of Surgicel® as a reservoir of analgesics at the potential pain generating sites following laparoscopic cholecystectomy, resulted in superior and extended postoperative analgesia with better patients’ satisfaction, and no serious adverse effects. | ||||
| Keywords | ||||
| Surgicel® fibrillar; analgesic reservoir; laparoscopies; Cholecystectomy; Postoperative; Analgesia; local anesthetics; pain management | ||||
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