Pre‐operative oral administration of morphine in day‐case gynaecological laparoscopy

Abstract

The analgesic efect of morphine sulphate 10 mg by mouth given pre-operatively on pain after gynaecological laparoscopy was studied in a randomised, prospective, double-blind, placebo-controlled comparison. Two groups of 56 patients were studied, one group undergoing diagnostic laparoscopy and the other laparoscopic sterilisation. AN patients received a standard anaesthetic after premedication with morphine or placebo I h before the operation. Morphine premedication did not significantly influence postoperatice pain as assessed on a visual analogue scale in either group and posloperative opioid consumption was unaffected.Premedication with morphine 10 mg orally does not sign$cantly decrease pain after day-case gynaecological laparoscopy .

A Comparison of Postoperative Pain With Preemptive Administration of Intravenous Ketorolac Versus Oral Ibuprofen in Patients Undergoing Interval Laparoscopic Bilateral Tubal Sterilization

“…Incisional pain is the third type of pain, and is caused by frocar insertion into the abdomen. Studies have not addressed it specifically because it is perceived as being incidental (Cade & Kakulas, 1995;Rasanayagam & Harrison, 1996;White, 1997) Spasmodic/cramping pain is the fourth type of pain, and like deep pelvic pain is attributable to the use of clips, rings, or electrocoagulation to occlude the fallopian tubes. This pain also has been depicted as being severe, but rarely persists for more than three to four hours (Dobbs et al, 1987: Edwards et al, 1991Guard & Wiltshire, 1996).…”

“…There may have been an even greater difference in pain intensity between the groups at the time of admission to recovery room, and in the immediate postoperative period. No discharge follow up was conducted, but the investigators justified this by stating they were targeting spasmodic type of pain, which usually subsides in three to four hoxu-s. Rasanayagam and Harrison (1996) looked at the analgesic effect of the preoperative oral administration of an opioid (morphine 10 mg) on VAS pain scores after gynecological laparoscopy. The researchers had been using morphine sulfate tablets preoperatively for laparoscopic patients, and clinically had the impression that the patients were more comfortable postoperatively.…”

“…Recently, opioids have been used preemptively (Rasanayagam & Harrison, 1996) Cabell (2000) investigated whether ketorolac could produce a preemptive analgesic effect in patients undergoing ambulatory laparoscopic gynecologic surgery.…”

“…Our take-home questionnaire revealed that 22 subjects (six hours after surgery), and 19 subjects (at bedtime) reported abdominal pain, hicisional pain is the fourth type of pain, and has been regarded as being incidental by other researchers. (Cade & Kakulas, 1995;Rasanayagam & Harrison, 1996;White, 1997). Six participants responded on the home questionnaire with complaints of incisional pain six hours after surgery, and eight had this type of pain at bedtime.…”

The Effect of Pre-Emptive Administration of Dextromethorphan on Postoperative Pain in Patients Undergoing Interval Laparoscopic Tubal Sterilization

“…Incisional pain is a direct result of surgical incision to tissues. Studies have not addressed this type of pain specifically because it is perceived as being incidental (Cade & Kakulas, 1995;Rasanayagam & Harrison, 1996;White, Joshi, Carpenter, & Fragen, 1997). Incisional pain is characterized as sharp and localized to immediate area of the trocar insertion sites.…”