Doaa H Abdelaziz1, Sherif Boraii2, Ejaz Cheema3, Mohamed Hassan Elnaem4, Tamer Omar5, Amr Abdelraouf6, Noha O Mansour7. 1. Department of Clinical Pharmacy, The National Hepatology and Tropical Medicine Research Institute, Egypt; Pharmacy Practice & Clinical Pharmacy Department, Faculty of Pharmaceutical Sciences and Pharmaceutical Industries, Future University in Egypt, Cairo, Egypt. Electronic address: Doaa.yousef@fue.edu.eg. 2. Department of Hepatobiliary Pancreatic Surgery, The National Hepatology and Tropical Medicine Research Institute, Egypt. Electronic address: Sherifbm@yahoo.com. 3. School of Pharmacy, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Electronic address: E.Cheema@bham.ac.uk. 4. Department of Pharmacy Practice, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia; Quality Use of Medicines Research Group, Faculty of Pharmacy, International Islamic University Malaysia, Kuantan, Pahang, Malaysia. Electronic address: drmelnaem@iium.edu.my. 5. Department of Anesthesia, The National Hepatology and Tropical Medicine Research Institute, Egypt. Electronic address: dromar30@yahoo.com. 6. Department of Hepatobiliary Pancreatic Surgery, The National Hepatology and Tropical Medicine Research Institute, Egypt. Electronic address: Abdelraoufamr@gmail.com. 7. Pharmacy Practice Department, Faculty of Pharmacy, Mansoura University, Egypt. Electronic address: dr.nohamansour@gmail.com.
Abstract
BACKGROUND:Pain after laparoscopic cholecystectomy remains a major challenge. Ondansetron blocks sodium channels and may have local anesthetic properties. AIMS: To investigate the effect of intraperitoneal administration of ondansetron for postoperative pain management as an adjuvant to intravenous acetaminophen in patients undergoing laparoscopic cholecystectomy. METHODS:Patients scheduled for elective laparoscopic cholecystectomy were randomized into two groups (n = 25 each) to receive either intraperitoneal ondansetron or saline injected in the gall bladder bed at the end of the procedure. The primary outcome was the difference in pain from baseline to 24-h post-operative assessed by comparing the area under the curve of visual analog score between the two groups. RESULTS: The derived area under response curve of visual analog scores in the ondansetron group (735.8 ± 418.3) was 33.97% lower than (p = 0.005) that calculated for the control group (1114.4 ± 423.9). The need for rescue analgesia was significantly lower in the ondansetron (16%) versus in the control group (54.17%) (p = 0.005), indicating better pain control. The correlation between the time for unassisted mobilization and the area under response curve of visual analog scores signified the positive analgesic influence of ondansetron (rs =0.315, p = 0.028). The frequency of nausea and vomiting was significantly lower in patients who received ondansetron than that reported in the control group (p = 0.023 (8 h), and 0.016 (24 h) respectively). CONCLUSIONS: The added positive impact of ondansetron on postoperative pain control alongside its anti-emetic effect made it a unique novel option for patients undergoing laparoscopic cholecystectomy.
RCT Entities:
BACKGROUND:Pain after laparoscopic cholecystectomy remains a major challenge. Ondansetron blocks sodium channels and may have local anesthetic properties. AIMS: To investigate the effect of intraperitoneal administration of ondansetron for postoperative pain management as an adjuvant to intravenous acetaminophen in patients undergoing laparoscopic cholecystectomy. METHODS:Patients scheduled for elective laparoscopic cholecystectomy were randomized into two groups (n = 25 each) to receive either intraperitoneal ondansetron or saline injected in the gall bladder bed at the end of the procedure. The primary outcome was the difference in pain from baseline to 24-h post-operative assessed by comparing the area under the curve of visual analog score between the two groups. RESULTS: The derived area under response curve of visual analog scores in the ondansetron group (735.8 ± 418.3) was 33.97% lower than (p = 0.005) that calculated for the control group (1114.4 ± 423.9). The need for rescue analgesia was significantly lower in the ondansetron (16%) versus in the control group (54.17%) (p = 0.005), indicating better pain control. The correlation between the time for unassisted mobilization and the area under response curve of visual analog scores signified the positive analgesic influence of ondansetron (rs =0.315, p = 0.028). The frequency of nausea and vomiting was significantly lower in patients who received ondansetron than that reported in the control group (p = 0.023 (8 h), and 0.016 (24 h) respectively). CONCLUSIONS: The added positive impact of ondansetron on postoperative pain control alongside its anti-emetic effect made it a unique novel option for patients undergoing laparoscopic cholecystectomy.
Authors: Abdelrahman N Emara; Noha O Mansour; Mohamed Hassan Elnaem; Moheb Wadie; Inderpal Singh Dehele; Mohamed E E Shams Journal: J Clin Med Date: 2022-05-31 Impact factor: 4.964
Authors: Noha O Mansour; Sherif Boraii; Mohamed Hassan Elnaem; Mahmoud E Elrggal; Tamer Omar; Amr Abdelraouf; Doaa H Abdelaziz Journal: Front Pharmacol Date: 2022-09-29 Impact factor: 5.988