بررسي تاثير داروي استازولاميد خوراكي بر روي ميزان درد بعد از عمل جراحي كوله سيستكتومي به روش لاپاروسكوپي

Assessment of oral acetazolamide on postoperative pain after laparoscopic cholecystectomy

Background and aim: Carbon dioxide (Co2) is used during laparoscopy for producing pneumoperitoneum. Combination of this gas with irrigation fluid in the abdomen produces carbonic acid which creates two kinds of abdominal and referred pain to right shoulder. In the present research, we have studied the effect of oral acetazolamide in reducing postoperative pain after laparoscopic cholecystectomy. Methods: This clinical trial was performed in 88 patients with cholelithiasis without any complication that were candidate for laparoscopic cholecystectomy. The patients devided randomly and equally in two groups. The experimental group received Acetazolamide (250mg orally, 24 hours before surgery, every 8 hours) and control group received placebo. Abdominal and shoulder pain measured using McGill pain score by a person who was blind for both groups. Pain measurement was performed in four different times, before and after the surgery, discharge from recovery and 24 hours after surgery. Data were analyzed by using SPSS software. Results: We observed that mean pain scores was significantly higher in acetazolamide group compared to the placebo group, 24 hours after the operation (P<0.05). However; no significant changes were observed 4 between groups in other times (P>0.05). Conclusion: Although acetazolamide can reduce abdominal pain referred to right shoulder by reducing acidity in peritoneal irrigation fluid, but this drug can increase abdominal pain in the site of surgery with damaged tissues by producing tissue acidosis (as a side effect of drug).