COMPARATIVE-STUDY OF PAIN LEVEL AND ANALGESIC REQUIREMENT AFTER LAPAROSCOPIC AND OPEN CHOLECYSTECTOMY

The laparoscopic technique of cholecystectomy leads to shorter hospita lization, faster recuperation, and earlier return to economic activity . Although reduction in pain is considered a major factor, no objectiv e clinical trial has confirmed this assumption. This prospective trial compared the pain level of laparoscopic (n = 28) and conventional (n = 11) cholecystectomy. The level of pain was determined by an independ ent observer using the visual analog scale (VAS). Intramuscular pethid ine or oral naproxen was given intermittently on demand. Patients who underwent the laparoscopic procedure had significantly less pain on th e day of operation (mean VAS score 3.8 vs. 7.7) and on the first posto perative day (mean VAS score 2.8 vs 6.2) (p < 0.05). The proportion of patients requiring intramuscular pethidine was correspondingly less i n the laparoscopy group. On the second and third postoperative day, th e level of pain was not statistically different. AU patients who had c onventional cholecystectomy required at least one dose of analgesia (p ethidine or naproxen), whereas only 53.6% of patients who had the lapa roscopic procedure required analgesia (p < 0.05). This study verifies that pain reduction is an important advantage of laparoscopic cholecys tectomy.