• Cielo Alborada Ureña-Frausto, Ricardo Plancarte-Sánchez, Juan Ignacio Reyes-Torres, and José Manuel Ramírez-Aranda.
• Departamento de Anestesiología, Hospital General de Cerralvo, Cerralvo, Nuevo León, Mexico. cielo_urena@hotmail.com
• Cir Cir. 2013 May 1;81(3):187-95.

IntroductionNeuraxial anesthesia in upper abdominal laparoscopic surgery decreases perioperative morbidity and mortality. However, shoulder pain is common and difficult to control. Use of a major opioid (e.g., fentanyl) for the control of this event may depress respiratory function. This is why we believe that a safe and effective therapeutic control of this disease pain is a multimodal analgesic scheme which we have called infusional therapy.ObjectiveTo compare various schemes for controlling shoulder pain secondary to pneumoperitoneum.MethodsNonrandomized clinical trial with 56 patients ASA I-II divided into four groups undergoing laparoscopic cholecystectomy. Group I (n= 15) managed with ketorolac 1 mg kg, group II (n = 12) ketoprofen 100 mg, group III (n = 14) ketoprofen 50 mg + 50 mg tramadol, and group IV (n = 15) ketoprofen 100 mg + 100 mg tramadol. The following ariables were analyzed: presence and intensity of pain, analgesia rescue and operative time.ResultsGroup I had more shoulder pain events compared to other groups (p= 0.002) in the same way the group IV required less rescue analgesia (p= 0.034).Conclusionpreemptive analgesia to infusional therapy with ketoprofen-tramadol at doses of 100 mg each is safe for laparoscopic surgery.

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