Surgicel® fibrillar as an innovative analgesic reservoir for post-laparoscopic cholecystectomy pain management: Randomized double-blind trial
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 su...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2022-12-01
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| Series: | Egyptian Journal of Anaesthesia |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/11101849.2022.2127524 |
| _version_ | 1811265528935743488 |
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| author | Esam Hamed Ragaa Herdan Ahmed M. Taha Abdullah AlHaddad Mohamed F. Mostafa |
| author_facet | Esam Hamed Ragaa Herdan Ahmed M. Taha Abdullah AlHaddad Mohamed F. Mostafa |
| author_sort | Esam Hamed |
| collection | DOAJ |
| description | 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 (p > 0.05), the longest time before requesting analgesia (p = 0.004), used least extra analgesia (p ≤ 0.001), maintained highest satisfaction scores (p ≤ 0.001), and lowest complications (p = 0.048). Group-I showed better results regarding pain control compared to group-III after 2 h (p = 0.02) with prolonged time to first analgesia (p < 0.001) and less analgesic consumption (p < 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. |
| first_indexed | 2024-04-12T20:25:26Z |
| format | Article |
| id | doaj.art-bccf64646cec408d9a29e51935ac4f0d |
| institution | Directory Open Access Journal |
| issn | 1110-1849 |
| language | English |
| last_indexed | 2024-04-12T20:25:26Z |
| publishDate | 2022-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Egyptian Journal of Anaesthesia |
| spelling | doaj.art-bccf64646cec408d9a29e51935ac4f0d2022-12-22T03:17:53ZengTaylor & Francis GroupEgyptian Journal of Anaesthesia1110-18492022-12-0138154254910.1080/11101849.2022.2127524Surgicel® fibrillar as an innovative analgesic reservoir for post-laparoscopic cholecystectomy pain management: Randomized double-blind trialEsam Hamed0Ragaa Herdan1Ahmed M. Taha2Abdullah AlHaddad3Mohamed F. Mostafa4Department of Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, Assiut, EgyptDepartment of Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, Assiut, EgyptDepartment of General Surgery, Faculty of Medicine, Assiut University, Assiut, EgyptDepartment of General and Colorectal Surgery, Mubarak Al-Kabeer Hospital, Hawalli, KuwaitDepartment of Anesthesia and Intensive Care, Faculty of Medicine, Assiut University, Assiut, EgyptBackground 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 (p > 0.05), the longest time before requesting analgesia (p = 0.004), used least extra analgesia (p ≤ 0.001), maintained highest satisfaction scores (p ≤ 0.001), and lowest complications (p = 0.048). Group-I showed better results regarding pain control compared to group-III after 2 h (p = 0.02) with prolonged time to first analgesia (p < 0.001) and less analgesic consumption (p < 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.https://www.tandfonline.com/doi/10.1080/11101849.2022.2127524Surgicel® fibrillaranalgesic reservoirlaparoscopiescholecystectomypostoperativeanalgesia |
| spellingShingle | Esam Hamed Ragaa Herdan Ahmed M. Taha Abdullah AlHaddad Mohamed F. Mostafa Surgicel® fibrillar as an innovative analgesic reservoir for post-laparoscopic cholecystectomy pain management: Randomized double-blind trial Egyptian Journal of Anaesthesia Surgicel® fibrillar analgesic reservoir laparoscopies cholecystectomy postoperative analgesia |
| title | Surgicel® fibrillar as an innovative analgesic reservoir for post-laparoscopic cholecystectomy pain management: Randomized double-blind trial |
| title_full | Surgicel® fibrillar as an innovative analgesic reservoir for post-laparoscopic cholecystectomy pain management: Randomized double-blind trial |
| title_fullStr | Surgicel® fibrillar as an innovative analgesic reservoir for post-laparoscopic cholecystectomy pain management: Randomized double-blind trial |
| title_full_unstemmed | Surgicel® fibrillar as an innovative analgesic reservoir for post-laparoscopic cholecystectomy pain management: Randomized double-blind trial |
| title_short | Surgicel® fibrillar as an innovative analgesic reservoir for post-laparoscopic cholecystectomy pain management: Randomized double-blind trial |
| title_sort | surgicel r fibrillar as an innovative analgesic reservoir for post laparoscopic cholecystectomy pain management randomized double blind trial |
| topic | Surgicel® fibrillar analgesic reservoir laparoscopies cholecystectomy postoperative analgesia |
| url | https://www.tandfonline.com/doi/10.1080/11101849.2022.2127524 |
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