Fast-track surgery protocols application in early recovery after surgery principle in the field of laparoscopic cholecystectomy anaesthetic support

Abstract

The purpose of the study was to improve the results of laparoscopic cholecystectomy anaesthetic support by the periand postoperative analgesia methods optimization. Laparoscopic cholecystectomy was performed in 136 patients with acute cholecystitis. Patients were randomized into 3 groups. The scheme of multimodal analgesia in patients of the 2nd and 3rd groups included paracetamol, dexketoprofen and nefopam with infiltration anaesthesia using bupivacaine and ropivacaine. The data obtained confirm the efficacy of multimodal analgesia regimen using abovementioned remedies in patients undergoing laparoscopic cholecystectomy. Bupivacaine and ropivacaine antinociceptive efficacy while providing infiltration anaesthesia in laparoscopic cholecystectomy dynamics was found to be comparable. The efficacy of the applied multimodal analgesia scheme was confirmed by adequate primary and secondary treatment results and suppression of pain syndrome and postoperative complications. Complex low-opioid anaesthesia during laparoscopic cholecystectomy reduced the use of nonsteroid antiinflammatory and analgesic remedies during the postoperative period. The authors believed the data obtained is a clinical background for the applied anaesthetic management scheme clinical effects check reasonability during laparoscopic operations in cases of acute gallbladder damage.