Surgical laparoscopy & endoscopy
-
Surg Laparosc Endosc · Oct 1994
Randomized Controlled Trial Comparative Study Clinical TrialIntramuscular diclofenac sodium for postoperative analgesia after laparoscopic cholecystectomy: a randomised, controlled trial.
Laparoscopic cholecystectomy is the surgical treatment of choice for symptomatic gallstones. Nonsteroidal antiinflammatory drugs offer effective analgesia, avoiding the central side effects of opiate drugs. To assess intramuscular diclofenac sodium (Voltarol; Ciba-Geigy) after laparoscopic cholecystectomy, 55 consecutive patients (41 female; 14 male; mean age: 50 years) were randomised to receive either diclofenac or placebo in double-blind fashion. ⋯ In 26 patients receiving diclofenac, median scores at 4 h were 1.6 (range 0-7.6) as compared with 4.1 (range 0-7.6) in 23 control patients (p = 0.05, 95% confidence limits 3.2, 0; Mann-Whitney U test). Nausea scores, return to diet, and time to discharge did not differ significantly between the groups. Intramuscular diclofenac significantly reduces early postoperative pain after laparoscopic cholecystectomy and is worthy of consideration if the procedure were ever undertaken as day case surgery.
-
Surg Laparosc Endosc · Oct 1994
Can pulse oximetry and end-tidal capnography reflect arterial oxygenation and carbon dioxide elimination during laparoscopic cholecystectomy?
An investigation was carried out on 13 ASA class 1 or 2 adult patients undergoing laparoscopic cholecystectomy. Throughout laparoscopy, the end-tidal PCO2 was continuously monitored by capnography and the arterial hemoglobin oxygen saturation by pulse oximetry. Also, repeated measurements of arterial blood gases were done. ⋯ The report showed that both the mean end-tidal PCO2 and arterial PCO2 progressively increased following carbon dioxide insufflation, to reach a maximal value after 30 min, with no significant change in the arterial-alveolar PCO2 gradient. Also, the arterial PO2 significantly decreased, and the hemoglobin oxygen saturation was always above 98% whether monitored by arterial blood gas analysis or by pulse oximetry. The results suggest that end-tidal capnography and pulse oximetry can be used as noninvasive techniques for monitoring arterial oxygenation and carbon dioxide elimination during laparoscopic cholecystectomy.