Efficacy of Methylprednisolone and Etoricoxib Combination to attenuate Post-operative Pain and Nausea/Vomiting in Laparoscopic Surgeries

ABSTRACT

Background and Aims:Pain and PONV (postopera?ve nausea and vomi?ng) are common complaints in the period following surgery. A mul?modal approach targe?ng the reduc?on of postopera?ve pain with an opioid-sparing analgesic along with an an?eme?c medica?on would minimize opioid consump?on and its associated side effects. We evaluated the efficacy of methylprednisolone 125 mg IV taken along with oral 120 mg etoricoxib on postopera?ve pain and PONV in pa?ents undergoing laparoscopic surgeries Material and methods:A prospec?ve, randomized, double-blind study was conducted on 70 pa?ents aged between 18 and 60 years with ASA grade 1 and 2 posted for elec?ve laparoscopic surgeries. The test group was given a combina?on of methylprednisolone 125mgIV (given just before induc?on)& etoricoxib120mg oral (given 1 hr before surgery). (Group A, n=35) while control group received normal saline IV and a placebo per oral(Group B, n=35). Dura?on and quality of analgesia was assessed by visual analogue scale (VAS) score at 2,4,6,8,10,12,16,20 and 24hr as primary objec?ve. Total dose of rescue analgesic(injec?on Fentanyl 50 mcg) in first 24 hours, peri-opera?ve hemodynamic change and post op nausea vomi?ng (PONV) were observed as secondary objec?ve. Result:Demographic profiles were comparable. Dura?on of postopera?ve analgesia was significantly prolonged(p<0.05) in Group A(7.57±1.04hrs) as compared to Group B(3.05±0.5hrs). Group A showed a significant reduc?on in postopera?ve fentanyl consump?on in the form of rescue analgesic(p<0.05). Group A also showed significant reduc?on in the incidence of PONV(p<0.05). Conclusion:We conclude that single-dose administra?on of methylprednisolone IV along with oral etoricoxib has be?er analgesic efficacy in comparison to placebo for pa?ents undergoing laparoscopic surgeries.