THE BEST THERAPEUTIC STRATEGY FOR ACUTE PAIN AFTER VIDEOLAPAROSCOPIC CHOLESCISTECTOMY: SYSTEMATIC REVIEW

• DOI: 10.22533/at.ed.15927622251110

• Palavras-chave: Pain. Postoperative. Cholecystectomy.

• Keywords: Pain. Postoperative. Cholecystectomy.

• Abstract:

  Introduction: Late mobilization, delayed discharge, development of chronic pain and increased treatment costs are negative consequences related to inadequate treatment of postoperative pain after laparoscopic cholecystectomy. Several studies propose therapeutic strategies to resolve acute pain after laparoscopic cholecystectomy. Objective: to identify the best therapeutic strategy for acute pain after laparoscopic cholecystectomy, among the available techniques. Methodology: This is a systematic review that included 13 full articles indexed in Medline, Scopus, Web of Science and LILACS databases. Literature review: In a multimodal analgesia proposal, as presented in the postoperative analgesia of videolaparoscopic cholecystectomy, it is important to consider drug interactions, side effects, contraindications, dosage and the ideal moment of interventions. Currently, opioids, non-steroidal anti-inflammatory drugs, selective cyclooxygenase-2 (COX-2) inhibitors, N-methyl-D-aspartate receptor antagonists and the use of gabapentin/pregabalin are mainly used. The particularities of the interactions and the heterogeneity of the presentations make the discussion fragile, but the individualized study of each case must be praised. It is known that opioids are good alternatives for analgesia and recent studies show that the use of oxycodone has shown promise, with a dose of 0.08mg/kg IV 20 minutes before the end of surgery. Conclusion: Although there is no consensus on the best therapeutic strategy, the applicability of the therapy must be individualized based on scientific evidence. The adverse effects of the drugs must be taken into account when choosing the therapy.