ROLE OF FLUPIRTINE AS A PROPHYLACTIC ANALGESIC IN PATIENTS HAVING LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

BACKGROUND: The International Association for the Study of Pain (IASP) describes pain as an unpleasant emotional and sensory experience connected to tissue damage that has occurred or may occur. The early mobilization and overall health of the surgical patient are significantly impacted by the prevention and treatment of postoperative pain, which remains a significant problem in postoperative care. Untreated post-operative pain has a negative impact on cost, length of hospital stay, and morbidity. It is also a serious health concern. Dorsal horn neurons become more sensitive after surgical activation, and this is linked to an increase in pain. Regional anesthesia, opioids, non-steroidal anti-inflammatory drugs, and local anesthetics remain the mainstays for post-operative analgesia treatment; however, their effects may be transient and they are invariably linked to the risk of respiratory depression, emesis, itching, and urine retention. Since postoperative pain is the most common complaint following laparoscopic cholecystectomy and can cause delays in the healing process, we conducted a prospective randomized trial to examine the potential benefits of flupirtine as a preventive analgesic for postoperative pain management in patients having the aforementioned procedure.

AIM: To evaluate the efficacy of oral flupirtine in reducing acute postoperative pain after laparoscopic cholecystectomy and to observe whether the drug has sedative or any other adverse effects.

MATERIAL AND METHOD: Eighty patients between the ages of 18 and 60 who were scheduled for a laparoscopic cholecystectomy under general anesthesia and who fit into ASA physical status I or II participated in the randomized, double-blind, prospective trial. A comprehensive pre-anesthetic examination was performed on each patient 48 hours before surgery. The Ramsay Sedation Score (RSS) and Visual Analogue Scale (VAS) were explained to them. Other crucial investigations and essential laboratory work were completed. Prior to the day of operation, written informed permission was obtained from each patient. Using computer-generated random numbers, participants in the trial were divided into two groups (A and B) of forty patients each.

RESULTS: Eighty adult patients participated in the study. They were split into two groups at random and given either a placebo or 200 mg of flupirtine orally two hours before general anesthesia was induced. It was discovered that there was no statistically significant difference between group A and group B's demographic profiles, including age, sex, and weight. Regarding demographics, length of anesthesia, total fentanyl intraoperative dose, total rescue analgesic demand (tramadol), and paracetamol required on the first postoperative day, there were no statistically significant differences. The length of surgery and the ASA physical status of groups A and B were determined to be non-statistically significant.

CONCLUSION: Giving 200 mg of flupirtine orally Painkillers that are administered two hours before a laparoscopic cholecystectomy work better than placebos in terms of reducing pain in the early postoperative phase. Without changing intraoperative hemodynamics, flupirtine can be utilized as a preventive analgesic with effective prolonging of analgesia in the early postoperative phase during laparoscopic procedures.

KEYWORDS: Flupirtine, Laparoscopic Cholecystectomy and Postoperative Analgesia