Renal function after laparoscopic cholecystectomy and analgesia with tramadol and dipyrone or ketorolac

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dc.contributor.authorMedeiros, Tiago Pechutti [UNESP]
dc.contributor.authorVianna, Pedro Thadeu Galvão [UNESP]
dc.contributor.authorSilva, Leopoldo Muniz da
dc.contributor.authorCarvalho, Lidia Raquel de [UNESP]
dc.contributor.authorWady, Gilberto Elias
dc.contributor.authorBraz, Leandro Gobbo [UNESP]
dc.contributor.authorCastiglia, Yara Marcondes Machado [UNESP]
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.date.accessioned2016-04-01T18:42:39Z
dc.date.available2016-04-01T18:42:39Z
dc.date.issued2013
dc.description.abstractBackground: Laparoscopic cholecystectomy (LC) reduces surgical trauma and hospital stay, but requires effective and safe postoperative analgesia. This prospective and double-blind study investigated the effects of analgesia with tramadol combined with either dipyrone or ketorolac on the postoperative renal function of patients submitted to LC. Methods: Pre- and postoperatively (PO), estimated glomerular filtration rates (GFR), obtained by two formulas dependent on blood Cr and one on blood cystatin C values, and tubular enzymuria—alkaline phosphatase (AP), γ-glutamiltransferase (γ-GT)— were determined in well hydrated patients who underwent LC and analgesia with tramadol combined with either dipyrone (Dipyrone, n = 63) or ketorolac (Ketorolac, n = 63). Upon discharge from the post-anesthetic care unit (PACU), pain (through Verbal Numerical Scale—VNS) and need for rescue analgesia with morphine were evaluated. Results: There was hemodilution PO, which made GFR profile analysis more difficult—those dependent on Cr increased and statistically correlated, but those dependent on cystatin C did not change. There was a significant PO increase in AP in the Dipyrone and Ketorolac groups, and in the product of the both enzymes in the Ketorolac group. Upon PACU discharge, the Dipyrone group showed significantly higher VNS scores than the Ketorolac group. All patients received morphine PO, and the total dose needed for pain control differed between groups, but without statistical significance. Conclusions: The association of tramadol with dipyrone or ketorolac in well hydrated patients submitted to LC had similar analgesic effectiveness in the PACU. Postoperatively, the effect on GFR may have been masked by hemodilution, and enzymuria was discreetly enhanced when ketorolac was used.en
dc.description.affiliationUnespUniversidade Estadual Paulista, Departamento de Anestesiologia, Faculdade de Medicina de Botucatu
dc.description.affiliationUnespUniversidade Estadual Paulista, Departamento de Bioestatística, Instituto de Biociências de Botucatu
dc.description.sponsorshipFundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)
dc.description.sponsorshipIdFAPESP: 07/51101-0
dc.format.extent35-41
dc.identifierhttp://dx.doi.org/10.4236/health.2013.511a1005
dc.identifier.citationHealth, v. 5, n. 11, p. 35-41, 2013.
dc.identifier.doi10.4236/health.2013.511a1005
dc.identifier.issn1949-4998
dc.identifier.lattes6507858203899415
dc.identifier.lattes7199562550978496
dc.identifier.urihttp://hdl.handle.net/11449/136808
dc.language.isoeng
dc.relation.ispartofHealth
dc.rights.accessRightsAcesso restrito
dc.sourceCurrículo Lattes
dc.subjectKidney function testsen
dc.subjectPneumoperitoneumen
dc.subjectBiological markersen
dc.subjectCystatin Cen
dc.subjectKetorolacen
dc.subjectAnalgesiaen
dc.titleRenal function after laparoscopic cholecystectomy and analgesia with tramadol and dipyrone or ketorolacen
dc.typeArtigo
unesp.author.lattes6507858203899415
unesp.author.lattes7199562550978496
unesp.author.orcid0000-0002-1927-8729[6]
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt
unesp.campusUniversidade Estadual Paulista (Unesp), Instituto de Biociências, Botucatupt
unesp.departmentAnestesiologiapt
unesp.departmentBioestatísticapt

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Artigos - Anestesiologia - FMB
Artigos - Bioestatística - IBB