Acetazolamide Reduces Referred Postoperative Pain after Laparoscopic Surgery with Carbon Dioxide Insufflation
Background Carbon dioxide is the preferred insufflating gas for laparoscopy because of greater safety in the event of intravenous embolism, but it causes abdominal and referred pain. Acidification of the peritoneum by carbonic acid may be the major cause of pain from carbon dioxide insufflation. Car...
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Ovid Technologies (Wolters Kluwer Health)
2003
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crovidcr:10.1097/00000542-200310000-00027 2024-09-15T18:01:37+00:00 Acetazolamide Reduces Referred Postoperative Pain after Laparoscopic Surgery with Carbon Dioxide Insufflation Woehlck, Harvey J. Otterson, Mary Yun, Hyun Connolly, Lois A. Eastwood, Daniel Colpaert, Krista 2003 http://dx.doi.org/10.1097/00000542-200310000-00027 http://pubs.asahq.org/anesthesiology/article-pdf/99/4/924/338041/0000542-200310000-00027.pdf http://journals.lww.com/00000542-200310000-00027 en eng Ovid Technologies (Wolters Kluwer Health) Anesthesiology volume 99, issue 4, page 924-928 ISSN 0003-3022 journal-article 2003 crovidcr https://doi.org/10.1097/00000542-200310000-00027 2024-08-08T04:24:26Z Background Carbon dioxide is the preferred insufflating gas for laparoscopy because of greater safety in the event of intravenous embolism, but it causes abdominal and referred pain. Acidification of the peritoneum by carbonic acid may be the major cause of pain from carbon dioxide insufflation. Carbonic anhydrase is an enzyme that increases the rate of carbonic acid formation from carbon dioxide. Because acetazolamide inhibits carbonic anhydrase, the authors hypothesized that the pain caused by carbon dioxide insufflation may be decreased by the administration of acetazolamide. Methods A prospective, randomized, double-blind study of 38 patients undergoing laparoscopic surgery during general anesthesia was performed. Acetazolamide (5 mg/kg) or a saline placebo was administered intravenously during surgery. Pain was rated on a visual analog scale (0-10) at four times: when first awake, at discharge from the recovery room, when discharged from the hospital, and on the day after surgery. The site and quality of pain were recorded, as were medications and side effects. Results Initial referred pain scores were lower after acetazolamide (1.00 +/- 1.98; n = 18) than after placebo (3.40 +/- 3.48; n = 20; P = 0.014), and 78% of patients in the acetazolamide group had no referred pain; however, only 45% patients in the placebo group had no referred pain. Incisional pain scores were not statistically different, and referred pain scores were similar at later times. Conclusions Acetazolamide reduces referred but not incisional pain after laparoscopic surgical procedures. The duration of pain reduction is limited to the immediate postsurgical period. Article in Journal/Newspaper Carbonic acid Ovid Anesthesiology 99 4 924 928 |
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Background Carbon dioxide is the preferred insufflating gas for laparoscopy because of greater safety in the event of intravenous embolism, but it causes abdominal and referred pain. Acidification of the peritoneum by carbonic acid may be the major cause of pain from carbon dioxide insufflation. Carbonic anhydrase is an enzyme that increases the rate of carbonic acid formation from carbon dioxide. Because acetazolamide inhibits carbonic anhydrase, the authors hypothesized that the pain caused by carbon dioxide insufflation may be decreased by the administration of acetazolamide. Methods A prospective, randomized, double-blind study of 38 patients undergoing laparoscopic surgery during general anesthesia was performed. Acetazolamide (5 mg/kg) or a saline placebo was administered intravenously during surgery. Pain was rated on a visual analog scale (0-10) at four times: when first awake, at discharge from the recovery room, when discharged from the hospital, and on the day after surgery. The site and quality of pain were recorded, as were medications and side effects. Results Initial referred pain scores were lower after acetazolamide (1.00 +/- 1.98; n = 18) than after placebo (3.40 +/- 3.48; n = 20; P = 0.014), and 78% of patients in the acetazolamide group had no referred pain; however, only 45% patients in the placebo group had no referred pain. Incisional pain scores were not statistically different, and referred pain scores were similar at later times. Conclusions Acetazolamide reduces referred but not incisional pain after laparoscopic surgical procedures. The duration of pain reduction is limited to the immediate postsurgical period. |
format |
Article in Journal/Newspaper |
author |
Woehlck, Harvey J. Otterson, Mary Yun, Hyun Connolly, Lois A. Eastwood, Daniel Colpaert, Krista |
spellingShingle |
Woehlck, Harvey J. Otterson, Mary Yun, Hyun Connolly, Lois A. Eastwood, Daniel Colpaert, Krista Acetazolamide Reduces Referred Postoperative Pain after Laparoscopic Surgery with Carbon Dioxide Insufflation |
author_facet |
Woehlck, Harvey J. Otterson, Mary Yun, Hyun Connolly, Lois A. Eastwood, Daniel Colpaert, Krista |
author_sort |
Woehlck, Harvey J. |
title |
Acetazolamide Reduces Referred Postoperative Pain after Laparoscopic Surgery with Carbon Dioxide Insufflation |
title_short |
Acetazolamide Reduces Referred Postoperative Pain after Laparoscopic Surgery with Carbon Dioxide Insufflation |
title_full |
Acetazolamide Reduces Referred Postoperative Pain after Laparoscopic Surgery with Carbon Dioxide Insufflation |
title_fullStr |
Acetazolamide Reduces Referred Postoperative Pain after Laparoscopic Surgery with Carbon Dioxide Insufflation |
title_full_unstemmed |
Acetazolamide Reduces Referred Postoperative Pain after Laparoscopic Surgery with Carbon Dioxide Insufflation |
title_sort |
acetazolamide reduces referred postoperative pain after laparoscopic surgery with carbon dioxide insufflation |
publisher |
Ovid Technologies (Wolters Kluwer Health) |
publishDate |
2003 |
url |
http://dx.doi.org/10.1097/00000542-200310000-00027 http://pubs.asahq.org/anesthesiology/article-pdf/99/4/924/338041/0000542-200310000-00027.pdf http://journals.lww.com/00000542-200310000-00027 |
genre |
Carbonic acid |
genre_facet |
Carbonic acid |
op_source |
Anesthesiology volume 99, issue 4, page 924-928 ISSN 0003-3022 |
op_doi |
https://doi.org/10.1097/00000542-200310000-00027 |
container_title |
Anesthesiology |
container_volume |
99 |
container_issue |
4 |
container_start_page |
924 |
op_container_end_page |
928 |
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1810438728284372992 |