A procedure-specific systematic review and consensus recommendations for postoperative analgesia following laparoscopic cholecystectomy

  • H. Kehlet
  • A. W. Gray
  • F. Bonnet
  • F. Camu
  • H. B. J. Fischer
  • R. F. McCloy
  • E. A. M. Neugebauer
  • M. M. Puig
  • N. Rawal
  • C. J. P. Simanski
Original article

DOI: 10.1007/s00464-004-2173-8

Cite this article as:
Kehlet, H., Gray, A.W., Bonnet, F. et al. Surg Endosc (2005) 19: 1396. doi:10.1007/s00464-004-2173-8

Abstract

Background:

Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain. However, a systematic review of postoperative pain management in this procedure has not been conducted.

Methods:

A systematic review was conducted according to the guidelines of the Cochrane Collaboration. Randomized studies examining the effect of medical or surgical interventions on linear pain scores in patients undergoing laparoscopic cholecystectomy were included. Qualitative and quantitative analyses were performed. Recommendations for patient care were derived from review of these data, evidence from other relevant procedures, and clinical practice observations collated by the Delphi method among the authors.

Results:

Sixty-nine randomized trials were included and 77 reports were excluded. Recommendations are provided for preoperative analgesia, anesthetic and operative techniques, and intraoperative and postoperative analgesia.

Conclusions:

A step-up approach to the management of postoperative pain following laparoscopic cholecystectomy is recommended. This approach has been designed to provide adequate analgesia while minimizing exposure to adverse events.

Keywords:

Laparoscopic Cholecystectomy Pain Analgesia Recommendations Procedure-specific 

Copyright information

© Springer Science+Business Media, Inc. 2005

Authors and Affiliations

  • H. Kehlet
    • 1
  • A. W. Gray
    • 2
  • F. Bonnet
    • 3
  • F. Camu
    • 4
  • H. B. J. Fischer
    • 5
  • R. F. McCloy
    • 6
  • E. A. M. Neugebauer
    • 7
  • M. M. Puig
    • 8
  • N. Rawal
    • 9
  • C. J. P. Simanski
    • 10
  1. 1.Section for Surgical Pathophysiology, 4074The Juliane Marie Centre RigshospitaletDenmark
  2. 2.Medical DepartmentChoice Medical CommunicationsHitchinEngland
  3. 3.Service Anesthesie ReanimationHôpital TenonFrance
  4. 4.Department of AnesthesiologyFlemish Free University of Brussels Medical CenterBelgium
  5. 5.Department of AnaesthesiologyAlexandra HospitalRedditchEngland
  6. 6.University Department of SurgeryManchester Royal InfirmaryEngland
  7. 7.Biochemical and Experimental Division, Medical FacultyUniversity of CologneGermany
  8. 8.Department of AnaesthesiologyHospital Universitario del Mar, Universidad Autonoma of BarcelonaSpain
  9. 9.Department of Anaesthesia and Intensive CareUniversity HospitalSweden
  10. 10.Department of Orthopaedic SurgeryMerheim Hospital, University of Witten-HerdeckeGermany

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