Effect of preemptive dezocine before general anesthesia on postoperative analgesia in patients undergoing laparoscopic cholecystectomy: A prospective observational study

Abstract

Dezocine is proposed as an adjunctive analgesic for postoperative pain control. This randomized, double-blind, controlled study aimed to investigate the effect of preoperative Dezocine therapy on postoperative pain following laparoscopic cholecystectomy as well as the underlying mechanisms.Eighty patients scheduled for laparoscopic cholecystectomy were randomly allocated into 2 groups as follows: patients in Group D received Dezocine 0.15 mg/kg before anesthesia induction and patients in Group S received same volume of saline. The pain intensity, sedation score, sufentanil-based patient-controlled analgesia (PCA) consumption were recorded for 24 hours after surgery. Plasma concentrations of norepinephrine and serotonin were also measured.During the first 24 hours after surgery, the patients in Group D experienced lower pain score assessed by numerical rating scale (NRS) at 3 hours (rest: P = .038; movement: P = .036), 6 hours (rest: P = .038; movement: P = .036), 12 hours (rest: P = .038; movement: P = .036), and 24 hours (rest: P = .038; movement: P = .036). Dezocine also decreased the sedation levels at 5 minutes (P = .031) after arrival at the PACU. Sufentanil-based PCA consumption in Group D was decreased when compared with Group S in the second to fourth phase after surgery (6-12 hours: P = .017; 12-18 hours: P = .003; 18-24 hours: P = .039). Plasma norepinephrine and serotonin concentrations were higher in the Group D at 24 hours after surgery (norepinephrine: P = .009, serotonin: P = .042). In addition, Group D showed less incidence of nausea/vomiting (P = .032) as well as a higher postoperative satisfaction score after surgery (P = .017).In conclusion, preemptive Dezocine administration is suggested to be useful for the management of postoperative pain in short-lasting surgery such as laparoscopic cholecystectomy.

Conflict of interest statement

The authors have declared that no conflict of interest exists.

Figures

Figure 1

Flowchart showing details of clinical procedures throughout the study.

Figure 2

Postoperative pain intensity and sedation levels. NRS score for pain at rest (A) and on movement (B) was assessed at 1 h (rest: P = .092; movement: P = .594), 3 h (rest: P = .038; movement: P = .036), 6 h (rest: P = .038; movement: P = 0.036), 12 h (rest: P = .038; movement: P = .036), and 24 h (rest: P = .038; movement: P = .036) after surgery in Group S (blue line) and Group D (red line). (C) Sedation levels were assessed using Ramsay scores at 5 min (P = .031), 10 min (P = .932), 15 min (P = .932), 30 min (P = .997), and 60 min (P = .210) after arrival at the PACU. NRS = numerical rating scale, PACU = postanesthetic care unit. ∗P < .05 versus Group S.

Figure 3

Levels of serotonin and norepinephrine in the plasma. Serotonin and norepinephrine levels were increased in Group D than in Group S at 24 h after surgery (Serotonin: P = .042; norepinephrine: P = .009). ∗P < .05, †P < .01 versus Group S.

Figure 4

Postoperative satisfaction score. Patients in Group D had a higher satisfaction score than that in Group S (P = .0079). ∗P < .05 versus Group S.