Recent research has revealed that opioids can act directly on the peripheral terminals of afferent nerves to mediate antinociception. The aim of this study was to assess the influence of peripheral morphine administration on the intensity of postoperative pain and requirement for analgesics in the postoperative period. This study involved 175 patients, who underwent scheduled laparoscopic cholecystectomy. The patients were randomly assigned to one of the 5 groups. In each group, IO minutes before the start of the surgical procedure, trocar insertion points were infiltrated with: in group S - 20 ml of 0,9% NaCI solution (5 ml of solution per each point), in group S+M - with 20 ml of 0,9% NaCI solution, and I O minutes before the start of the operation, patients were given 2 mg of subcutaneous morphine, in group M - with 2 mg of morphine in 20 ml of 0,9% NaCI solution, in group B - with 20 ml of 0,25% bupivacaine solution and in group M+B - with 2 mg of morphine in 20 ml of 0,25%bupivacaine solution. Pain medication after the surgery was administered by nursing personnel only when requested by the patient. The on-request tramadol dose was 100 mg. After surgery, the following were measured: postoperative pain intensity scored by VAS scale, the time to the first dose of tramadol, tramadol requirement in individual research groups and frequency of undesirable side effects. Post ; operative pain intensity was lower in group M compared with group S. The time elapsed from the completion of the surgical procedure to the administration of the first dose of tramadol was longer in group M compared with groμp S. No differences in total tramadol requirement in the postoperative period occured between the groups. Frequency of undesirable side effects was similar in all research groups. The results of this study confirm the possibility of modifying the nociception process inthe postoperative period through peripheral opioids administration.
Jul 18, 2022
Nov 21, 2012
|ZB-102793||Jul 18, 2022|
Kościelniak-Merak, Barbara Karolina