[Reduction of omalgia in laparoscopic cholecystectomy: clinical randomized trial ketorolac vs ketorolac and acetazolamide].

Abstract

BACKGROUND:

Laparoscopy cholecystectomy for the surgical treatment of cholelithiasis has been considered the gold standard. The referred pain to the shoulder (omalgia) may be present to 63% of the patients and limits outpatient management.

OBJECTIVE:

The study was to evaluate the usefulness of acetazolamide associated with ketorolac for reduction of the omalgia to minimally invasive treatment.

METHODS:

We performed a clinical trial, randomized, double blind in patients undergoing laparoscopic cholecystectomy to assess the reduction of post-operative omalgia comparing ketorolac and ketorolaco+acetazolamida. 31 patients in each group were studied. The study group: 250 mg of acetazolamide before anesthetic induction and 30 mg of ketorolac in the immediate postoperative period.

CONTROL GROUP:

one tablet of placebo prior to the anesthetic induction and 30 mg of ketorolac in the immediate postoperative. The presence of omalgia was assessed using the analog visual scale. The variables recorded included: age, sex, flow of carbon dioxide intra-abdominal pressure, surgical time, urgent or elective surgery, omalgia, severity of pain evaluated by analog visual scale, addition analgesia.

RESULTS:

Both groups were homogeneous and statistical analysis showed no differences in the variables studied. The omalgia in the study group was presented at 9.67% and in the group control was the 58.06% (p < 0.001).

CONCLUSION:

250 mg oral acetazolamide associated 30 mg of ketorolac reduces significantly the development of omalgia in patients undergoing laparoscopic cholecystectomy.

• Authors: Lorena Figueroa-Balderas, Francisco Franco-López, Efrén Flores-Álvarez, Jorge Luis López-Rodríguez, José Antonio Vázquez-García, Claudia Teresa Barba-Valadez
• Journal: Cirugia y cirujanos (Cir Cir) 2013 Sep-Oct Vol. 81 Issue 5 Pg. 368-72 ISSN: 2444-054X [Electronic] Mexico
• Vernacular Title: Reducción de omalgia en colecistectomía laparoscópica: ensayo clínico aleatorizado con ketorolaco vs ketorolaco y acetazolamida.
• PMID: 25125053 (Publication Type: Comparative Study, English Abstract, Journal Article, Randomized Controlled Trial)

Chemical References

• Anti-Inflammatory Agents, Non-Steroidal
• Carbonic Anhydrase Inhibitors
• Carbon Dioxide
• Acetazolamide
• Ketorolac

Topics

• Acetazolamide (administration & dosage, therapeutic use)
• Adult
• Anti-Inflammatory Agents, Non-Steroidal (administration & dosage, therapeutic use)
• Carbon Dioxide (administration & dosage, pharmacokinetics)
• Carbonic Anhydrase Inhibitors (administration & dosage, therapeutic use)
• Cholecystectomy, Laparoscopic
• Cholelithiasis (epidemiology, surgery)
• Drug Therapy, Combination
• Female
• Humans
• Ketorolac (administration & dosage, therapeutic use)
• Male
• Mexico (epidemiology)
• Middle Aged
• Pain Measurement
• Pain, Postoperative (drug therapy, etiology, prevention & control)
• Pain, Referred (drug therapy, etiology, prevention & control)
• Pneumoperitoneum, Artificial (adverse effects)
• Preanesthetic Medication
• Shoulder Pain (drug therapy, etiology, prevention & control)