Effect of Pain Medication Choice on Emergency Room Visits for Pain after Ambulatory Laparoscopic Cholecystectomy

Abstract

Inadequate pain control after ambulatory surgery can lead to unexpected return visits to the hospital. The purpose of this study was to compare patients based on which medications they were prescribed and to see whether this affected the rate of return to the hospital. A retrospective chart review of patients who underwent ambulatory laparoscopic cholecystectomy between January 2009 and December 2013 was performed. Patients were divided into two groups based on the pain medication prescribed after surgery: Opioids and nonopioids. Patients returning to the Emergency room (ER) within seven days were evaluated. If no complication or other diagnosis was identified, the patient was considered to have returned for inadequate pain control. The two groups were statistically compared with each other using Fisher's exact chi-squared test. A total of 749 patients underwent laparoscopic cholecystectomy during the study period: 180 (25.2%) were prescribed opioids, whereas, 560 (74.8%) were prescribed nonopioids. In the nonopioid group, 14 (1.9%) returned to the ER for pain, whereas no patient in the opioid group returned for pain. This difference was statistically significant ( P = 0.027). In conclusion, patients who were given opioid pain medications after ambulatory laparoscopic cholecystectomy were less likely to return to the ER for pain. This implied that opioids were better at pain control and helped avoid the costs of unnecessary ER visits. Future research should be aimed at more direct measures of pain control, as well as the role of opioids after inpatient surgery.

Transversus Abdominis Plane (TAP) Block for Postoperative Analgesia After Laparascopic Cholecystectomy, a retrospective study

“…However, patients undergoing laparoscopic cholecystectomy have abdominal and shoulder tip pain leading to patient's discomfort (8) . Inadequate pain control delays the recovery and prolongs the time to discharge so the advantage factor of laparoscopic procedure may be lost especially in planned day-case surgery (9) . Postoperative abdominal and shoulder tip pain, nausea and vomiting due to peritoneal stretching and diaphragmatic irritation are induced by pneumoperitoneum and residual CO 2 (8) .…”

Intraperitoneal Using of Bupivаcain for the Anesthesia of Patients After Laparoscopic Cholecystectomy

“…Âèðàaeåíèé ÏÁÑ â ïåðøó äîáó ï³ñëÿ ËÕÅ ðîçâèâàºòüñÿ ó 14-41 % õâîðèõ, ³ º îäí³ºþ ç ïðè÷èí òðèâàëî¿ âòðàòè ïðàöåçäàòíîñò³. Äëÿ çìåíøåííÿ ÏÁÑ áóëî çàïðîïîíîâàíî áàãàòî ð³çíèõ ìåòîäèê, ñåðåä ÿêèõ çàñòîñóâàííÿ íàðêîòè÷íèõ òà íåíàðêîòè÷íèõ àíàëüãåòèê³â, íåñòåðî¿äíèõ ïðîòèçàïàëüíèõ çàñîá³â, çíèaeåííÿ òèñêó ïðè ïðîâåäåíí³ ïíåâìîïåðèòîíåóìó, çìåíøåííÿ ê³ëüêîñò³ îòâîð³â äëÿ òðîàêàð³â [13].…”