Evaluation of nicotine patch in pain control of patients undergoing laparoscopic cholecystectomy

ABSTRACT Objective: to analyze the effects of nicotine patch on pain control, occurrence of nausea and its hemodynamic repercussions in laparoscopic cholecystectomy procedures. Methods: we conducted an analytical, prospective, randomized, triple-blinded, clinical study between January and July 2017. The sample consisted of 17 patients who underwent laparoscopic cholecystectomy for the treatment of cholelithiasis. Nine patients used nicotine patch, and eight, placebo patch. The studied variables were pain, nausea, patient satisfaction, blood pressure, heart rate, oximetry and morphine rescue. Results: taking into account the pain and nausea parameters, there was no statistically significant difference between the groups (p>0.05). Also, the evaluation of rescue medication, both opioids and prokinetics, did not show any significant statistical difference between the groups. Among the hemodynamic parameters, there was only one statistically significant difference in the analysis of oxygen saturation and systolic blood pressure (SBP) six hours after surgery: the mean oxygen saturation was higher in the Test group (97.89 x 95.88) and the mean SBP was higher in the Control group (123.89 x 110.0). Conclusion: although pain levels were lower for nicotine within 24 hours, the action of nicotine and the need for rescue opioids in pain control were not statistically significant between the groups and at the time intervals studied. There was no clinical repercussion in the hemodynamic parameters.

目的：本研究旨在探讨腹腔镜胆囊切除术（laparoscopic cholecystectomy）中应用尼古丁贴剂（nicotine patch）对疼痛控制、恶心发生情况及其血流动力学的影响。
方法：本研究为分析性前瞻性随机三盲临床试验，于2017年1月至7月间开展。研究纳入17例因胆石症（cholelithiasis）行腹腔镜胆囊切除术的患者，其中9例使用尼古丁贴剂，8例使用安慰剂贴剂（placebo patch）。本研究观察指标包括疼痛程度、恶心发生情况、患者满意度、血压、心率、血氧饱和度及吗啡补救镇痛用量。
结果：两组患者的疼痛及恶心相关指标均无统计学差异（p>0.05）；阿片类（opioids）及促动力类（prokinetics）补救药物的使用情况亦无显著统计学差异。血流动力学指标方面，仅术后6小时的血氧饱和度与收缩压（SBP, systolic blood pressure）分析存在统计学差异：试验组（尼古丁贴剂组）平均血氧饱和度更高（97.89 vs 95.88），对照组（安慰剂贴剂组）平均收缩压更高（123.89 vs 110.0）。
结论：尽管术后24小时内尼古丁贴剂组的疼痛程度更低，但在本研究覆盖的各时间区间内，两组间尼古丁的镇痛效果及补救性阿片类药物使用需求均无统计学差异，血流动力学参数未出现具有临床意义的变化。