The Role of Multimodal Analgesia in Patients with Tubal Pathology Treated by Laparoscopic Surgery

REZUMAT THE ROLE OF MULTIMODAL ANALGESIA IN PATIENTS WITH TUBAL PATHOLOGY TREATED BY LAPAROSCOPIC SURGERY Laura Gavril1, Adrian Cotirlet2, Florentina Pricop3 Objective: The aim of the study is to highlight the benefits of multimodal analgesia in the treatment of postoperative pain in patients with tubal pathology operated by laparoscopic surgery compared to classical postoperative pain management. Material and method: This study is a prospective one and included a number of 44 patients operated by laparoscopic surgery for tubal pathology. The patients were randomly divided into two groups: the study group (22 patients) received preand intraoperative multimodal analgesia, which included a COX-2 inhibitor (parecoxib) i.v. before induction of anesthesia, levobupivacaine infiltration before skin incision and intraperitoneal administration of levobupivacaine at the beginning and at the end of the procedure, and the control group (22 patients) had general anesthesia without any preor intraoperative nonopioid analgesic. Evaluation of postoperative pain intensity was performed in both groups, at rest,static, and during mobilization, dynamic, at first at 4 hours and then at 8, 12 and 24 hours. Results: In the first 12 hours postoperatively the mean pain score at rest in the study group was 2,98±0,53 compared to 4,66±1,15 in the control group and the mean pain score during mobilization was 3,81±0,88 in the study group compared to 5,91±1,47 in the control group. Incidence of PONV was lower, mobilization and hospital discharge were faster for patients in the study group. Conclusion: Preand intraoperative multimodal management of postoperative pain resulted in lower VAS pain scores at rest and during mobilization compared to classical postoperative pain treatment.