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Multimodal Preincisional Premedication to Prevent Acute Pain After Cholecystectomy

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Author(s): Dawood Aghamohammadi | Hamzeh Hosseinzadeh | Mahmood Eidy | Zahra Mohammadzadeh Vizhe | Mohammad Bassir Abolghasemi Fakhri | Reza Movassaghi | Kamyar Ghabili | Samad EJ Golzari

Journal: Journal of Cardiovascular and Thoracic Research
ISSN 2008-5117

Volume: 4;
Issue: 3;
Start page: 65;
Date: 2012;
Original page

Keywords: Postoperative Pain | Multimodal Analgesia | Postoperative Opioid

ABSTRACT
Introduction: Postoperative pain as an important medical concern is usually treated by opioids which also are of various inevitable side effects. The aim of this study was to assess the efficacy of multimodal preincisional premedication on preventing post-cholecystectomy acute pain. Methods: In a randomized clinical trial, sixty patients undergoing open cholecystectomy were randomized into two groups. Before anesthesia induction, Diclofenac suppository (100 mg) and oral Clonidine (0.2 mg) were administered in the first group. Immediately before operation, patients received Ketamine (1 mg/kg IV) while the control group received placebo. The site of incision was infiltrated by the surgeon with 20 mL Bupivacaine 0.25% in both groups. Anesthesia induction and maintenance were similar in both groups. The severity of pain was recorded 2, 4, 6, 12, 24 and 48 hours after operation according to Visual Analogue Scale. Results: The severity of pain at two defined stages (6 and 12 hours later) was significantly less in the intervention group than the control group (P
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