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  • Multimodal compound analgesia after the laparoscopic cholecystectomy = Sestavljena (modulirana) analgezija po endoskopsko odstranjenem žolčniku
    Cesar-Komar, Marija ; Vodopija, Nado ; Zajec, Miha
    Background. The pain after the cholecystectomy is multifacctorial and as well somatic as visceral (1). The damage of tissues and cells is accompanied by released tissue pain mediators which sensitize ... or excite the nociceptors. The inflammation components also activate the cascadicpain transmission and pain modulation. The pneumoperitoneum also causes many pain impulses. The intense and very long lasting excitation causes alterations within the central nervoussystem, because of the plasticity of the nervous system with peripheraland central (hypersensitisation) hyperalgesia. The aim of our study is to achieve the multimodal, compound analgesia around (pre and postoperatively) the endoscopic cholecystectomy, with minimal side effects. Itis a combination of infiltration of surgical ports with local anaestheticforlaparoscopic instruments before the surgery, and the infiltration of the bed of the cholecyst but after its removal by local anaesthetic (bupivacain) in a combination of continous infusion of minimal doses of the medium strong opioid analgesic tramadol after the operation. Materials and methods. The study was accepted by the Republic Medical Ethic Commission. The study design has been randomized, prospective, double blind case-control, with the use of the local anaesthetic (0,125% bupivacain) or placebo (0, 9% NaCl). In this study patients for the elective endoscopic cholecystectomy were included all from the surgical and urological department of the general hospital in Slovanj Gradec, in the period from April till December 1998. (Abstract truncated at 2000 characters.)
    Vir: Zdravniški vestnik : glasilo Slovenskega zdravniškega društva = Slovenian medical journal = journal of Slovenian Medical Association. - ISSN 1318-0347 (Letn. 68, št. 10, okt. 1999, str. 549-554)
    Vrsta gradiva - članek, sestavni del
    Leto - 1999
    Jezik - angleški
    COBISS.SI-ID - 10545881

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