Acetazolamide reduces postoperative pain following laparoscopic inguinal herniorrhaphy

Pourladian, Irene S.; Lois, Alex W.; Frelich, Matthew J.; Woehlck, Harvey J.; Weber, Michelle; Kastenmeier, Andrew; Gould, Jon C.; Goldblatt, Matthew I.

doi:10.1007/s00464-015-4564-4

Cited by 4 publications

(8 citation statements)

References 12 publications

(19 reference statements)

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“…The Risk of Bias (RoB 2.0) tool was used to establish low publication bias for the four randomized control trials 4 , 6 – 8 ( Figure 2A ). The Risk of Bias in Nonrandomized Studies of Intervention (ROBIN-S) tool was used to assess a low level of bias overall and across all categories except measurement of outcome, where it ranked moderate, due to a lack of sufficient blindness 5 ( Figure 2B ).…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…The two other included studies both administered the ACTZ preoperatively. 4 , 5 In the study by Pourladian et al, patients in the treatment group received 250 mg of ACTZ prior to surgery, though the route of administration was not specified. Patients in the treatment group in the study by Bala et al were given 5 mg/kg oral ACTZ preoperatively.…”

Section: Resultsmentioning

confidence: 99%

“…7 Another study included patients who were undergoing inguinal herniorrhaphy. 5 The final study included patients receiving LSC for several different surgical procedures, including gynecologic, cholecystectomy, gastric bypass, herniorrhaphy, and lymph node dissection. 8 In regard to timing of administration of the ACTZ, three of the included studies had patients in the treatment groups receive the ACTZ intra-operatively.…”

Section: Key Characteristics and Findings Of Studies Includedmentioning

confidence: 99%

“…[1][2][3] In addition, studies have also proposed a novel use of the medication acetazolamide (ACTZ). [4][5][6][7][8] however, given its mechanism of action, it has been utilized and studied as a means of reducing postoperative pain after laparoscopy. It works by inhibiting the carbonic anhydrase enzyme, which is responsible for the conversion of CO 2 and water to carbonic acid.…”

Section: Introductionmentioning

confidence: 99%

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Systematic Review and Meta-Analysis of Perioperative Administration of Acetazolamide for Management of Postoperative Pain after Laparoscopy

McGrail

Chapple

Stone

et al. 2022

JSLS

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Background and Objective: To perform a systematic review and meta-analysis to evaluate the efficacy of perioperative acetazolamide (ACTZ) administration with laparoscopy for reducing postoperative referred pain. Methods: The following databases were searched from inception to March 1, 2020: Cochrane, PubMed, PubMed Central, Ovid, and Embase. Electronic search used: Acetazolamide AND (laparoscopy OR laparoscopic OR Celioscopy OR Celioscopies OR Peritoneoscopy OR Peritoneoscopies). No limits or filters were used. We included only studies of patients who underwent abdominal laparoscopy (LSC), had a pain assessment at approximately 24 hours postoperatively, and included a treatment with ACTZ group and a no-treatment or minimal-treatment comparison group. Results: Five studies met inclusion criteria, with a combined total of 253 participants, 116 in the ACTZ group and 137 in the control group. A Bayesian hierarchical model was assumed for the study specific treatment effects. Posterior sampling was conducted via Markov Chain Monte Carlo methods, and posterior inference carried out on the hierarchical treatment effect. ACTZ significantly decreased average pain scores compared to control group by −0.726 points (95% confidence interval −1.175–0.264). The posterior probability that ACTZ decreases mean pain scores by ≥ 0.5 was 0.846. Conclusion: Current available evidence demonstrates that perioperative ACTZ may provide a modest improvement in postoperative referred pain following LSC.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Key Characteristics and Findings Of Studies Includedmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Systematic Review and Meta-Analysis of Perioperative Administration of Acetazolamide for Management of Postoperative Pain after Laparoscopy

McGrail

Chapple

Stone

et al. 2022

JSLS

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Premedication with acetazolamide: Is its use for postoperative pain and stress control after laparoscopic ovariectomy in dogs ruled out?

Tavares

Rivero

Sales-Luís

et al. 2023

Veterinary Medicine & Sci

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Background: Studies in human medicine have concluded that acetazolamide reduces pain associated with carbon dioxide insufflation during laparoscopic surgery. However, there are no published reports regarding the use of acetazolamide for this purpose in companion animals, despite the increasing popularity of laparoscopic techniques in veterinary medicine due to their advantages over open surgeries.Objectives: Thirty mixed-breed female dogs were included in the study and randomly assigned to one of three groups: OVE (median celiotomy ovariectomy; n = 10), OVEL (laparoscopic ovariectomy, n = 10) and OVELA (laparoscopic ovariectomy with acetazolamide preoperative administration; n = 10). Experienced surgeons performed all procedures, and the anaesthetic and analgesic protocols were identical for all animals.Acetazolamide was administered orally (at a dose of 25 mg/kg) 2 h prior to induction in the OVELA group. Postoperative pain was evaluated using serum cortisol, salivary cortisol, and the University of Melbourne Pain Scale (UMPS) Score.Results: Any statistical differences were observed in the UMPS scores when the OVELA group was compared to the OVEL group at 1 h after surgery (p = 0.515), 12 h (p = 0.375) and 24 h (p = 0.242). Animals undergoing open surgery (OVE group) had significantly higher pain scores at all times after surgery when compared with OVEL and OVELA groups. A high positive correlation (r = 0.792; p = 0.01) was found between serum and saliva cortisol concentrations. Mean saliva cortisol concentration was not significantly lower for the OVELA group compared to the other groups.Conclusions: This study found evidence that preoperative administration of acetazolamide may be beneficial in managing postoperative pain in dogs after laparoscopic surgeries. However, further research with a larger sample size is needed to confirm this and to determine if acetazolamide should be included in a multimodal postoperative analgesia protocol for laparoscopic ovariectomy in dogs.

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Impact of Acetazolamide on Perioperative Pain Control in Robotic Assisted Laparoscopic Prostatectomy

Medairos¹,

Lankford²,

Everett³

et al. 2023

Urology

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Acetazolamide reduces postoperative pain following laparoscopic inguinal herniorrhaphy

Abstract: Acetazolamide appears to reduce pain in the immediate postoperative setting. Patients who received acetazolamide had lower pain scores postoperatively and required fewer narcotics for pain management prior to discharge.

Cited by 4 publications

References 12 publications

Systematic Review and Meta-Analysis of Perioperative Administration of Acetazolamide for Management of Postoperative Pain after Laparoscopy

Systematic Review and Meta-Analysis of Perioperative Administration of Acetazolamide for Management of Postoperative Pain after Laparoscopy

Premedication with acetazolamide: Is its use for postoperative pain and stress control after laparoscopic ovariectomy in dogs ruled out?

Impact of Acetazolamide on Perioperative Pain Control in Robotic Assisted Laparoscopic Prostatectomy

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