Physician
Sanne Vibe Nielsen
Hospital of South West Jutland
| Projekt styring | ||
| Projekt status | Open | |
| Data indsamlingsdatoer | ||
| Start | 02.06.2022 | |
| Slut | 31.12.2025 | |
Intraoperative Administration of intravenous morphine in patients undergoing laparoscopic cholecystectomy
Short summary
The goal og this observational, quality improvement study is to compare the effect of a dose of morphine given during elective laparoscopic cholecystectomy. We wish to investigave if patients given morfine intraoperatively experiece less pauin postoperatively. We will also investigate if there are sign of increased postoperative nausea and vomiting or prolonges stay in the postoperative ward.
Rationale
Pain following laparoscopic cholecystectomy is complex and stems from several stimuli: e.g. skin-incisions, abdominal distention due to pneumoperitoneum and irritation of the phrenic nerve. Postoperative pain continues to be a problem despite years of focus on the issue as well as increased use of laparoscopic and minimally invasive, surgical technique. This holds true for laparoscopic cholecystectomy as well. Some investigators report that as much as 50-70% of patients experience moderate to intensive pain postoperatively. It is well known that postoperative pain causes increased morbidity and is a primary cause of prolonged length of hospital stay.1 Multimodal analgesic approach is recommended for this type of surgery. Because use of opioids frequently cause adverse effects an opioid-sparing approach is recommended. However, non-opioid analgesia also has the potential for adverse effects. Even if it is possible to perform opioid-free anesthesia knowledge and evidence is still sparse, and peri- and postoperative opioid rescue analgesia is often necessary. We hypothesize, that multimodal analgesia including a perioperative dose of morphine (0,1 mg/kg) given 20 minutes after start of surgery will have beneficial effect on postoperative pain without causing significant increase in opioid related adverse effects.
Description of the cohort
Patients presenting for elektive laparoscopic cholecystectomy Excl. critera: - age under 21 - patients unable to consent to anesthesia - patient unable to participaine in pain scoring by nummerical ranking scale - patients with chronic pain syndromes, charactarized by regular analgesic treatment, an/or previous or avtive contact til pain clinic - patients with any previous or active substance abuse - patients presenting for acute or subacute surgery
Data and biological material
None
Collaborating researchers and departments
Department of anesthesiology and intensive Care, Esbjerg Sygehus