Date of Award

5-2022

Document Type

Scholarly Project

Degree Name

Master of Physician Assistant Studies (MPAS)

Department

Physician Assistant Studies

First Advisor

Julie Solberg

Keywords

Analgesics; Laparoscopic cholecystectomy, humans; Postoperative pain; Opioid analgesics; Nonopioid analgesics; Gabapentin; Pregabalin; NSAIDs; Acetaminophen

Abstract

The purpose of this research and systematic literature review is to determine effective pain management options for patients undergoing a cholecystectomy procedure while decreasing the use of postoperative narcotics. In this review, the databases searched included PudMed, Clinical Key and Dynamed Plus. A variety of key terms were used when searching. Studies chosen from this search were peer reviewed and included randomized control trials, systematic reviews and met analyses. Excluded studies did not particularly research the drug classes of interest or they dealt solely with different surgical pain interventions during the procedure. The research presented shows the use of gabapentinoids, non-steroidal anti-inflammatory drugs and acetaminophen to reduce opioid use in the postsurgical period. Of the medications reviewed, preoperative use of oral acetaminophen and non-steroidal anti-inflammatory drugs offer the greatest reduction in opioid use, while offering sufficient pain control. For gabapentinoids, additional research is needed to determine optimal dosing and to balance analgesic benefits with potential adverse effects.

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