The following is a summary of “Impact of Acetazolamide on Perioperative Pain Control in Robotic Assisted Laparoscopic Prostatectomy,” published in the FEBRUARY 2023 issue of Urology by Medairos, et al.
For a study, researchers sought to determine the effectiveness of perioperative acetazolamide for pain control in robotic-assisted laparoscopic prostatectomy (RALP). Prior research has shown that preoperative acetazolamide reduced postoperative referred pain after surgery for laparoscopic procedures. The suggested mechanism is the suppression of carbonic anhydrase by acetazolamide, which prevents the generation of carbonic acid and the associated peritoneal acidosis with referred pain. However, in the context of RALP, this has yet to be proven.
About 31 patients undergoing RALP were randomized to receive either preoperative saline or acetazolamide. Pain scores were recorded at various time points postoperatively, and total morphine equivalents administered were also noted.
Of the 31 patients, 16 (51.6%) received perioperative acetazolamide, while 15 (48.4%) received perioperative saline. The overall pain scores at different time points did not differ significantly between the two groups. First responsive (3.5 ± 3.1 vs. 4.1 ± 1.7, P = .28). The pain scores before leaving the post-anesthesia care unit (PACU) were 2.8 ± 2.9 and 2.9 ± 2.9 for acetazolamide and saline groups, respectively (P = .48). The pain scores at 4 hours post-procedure were 3.1 ± 3.0 and 2.9 ± 1.8 for acetazolamide and saline groups, respectively (P = .362), while at 24 hours post-procedure, the pain scores were 2.3 ± 1.7 and 2.2 ± 1.6 for acetazolamide and saline groups, respectively (P = .5). Shoulder tip pain was not reported in either group. There was no significant difference in total morphine equivalents administered between the two groups (17.3 vs. 20.5, P = .2, respectively).
Perioperative acetazolamide did not significantly impact overall or shoulder tip pain in patients undergoing RALP.
Source: goldjournal.net/article/S0090-4295(22)00987-6/fulltext
