Pre-operative Recommendations for Laparoscopic Cholecystectomy

Pre-operative Recommendations for Laparoscopic Cholecystectomy

PRE-OPERATIVE RECOMMENDED	NOT RECOMMENDED
SYSTEMIC ANALGESIA   Corticosteroid –          dexamethasone (Grade B for analgesic effects; Grade A for anti-emetic effects)   COX-2-selective inhibitors –          (Grade B)     Gabapentinoids –          gabapentin (Grade B)	SYSTEMIC ANALGESIA   Alpha-2-adrenergic receptor agonists –          clonidine (Grade D)   Conventional NSAIDs –          (Grade B)   IV LA –          (Grade D)   NMDA antagonist –          dextromethorphan (Grade D) –          ketamine (Grade D) –          magnesium (Grade B)   Strong opioids –          strong opioids (Grade B)   Weak opioids –          tramadol (Grade B)   Paracetamol –          (Grade B)
REGIONAL ANALGESIA   LA wound infiltration –          long-acting LA wound infiltration (Grade A)  for reducing wound pain but not shoulder pain   Epidural analgesia –          in high-risk pulmonary patients (Grade D)	REGIONAL ANALGESIA   Paravertebral block –          (Grade D)   Spinal LA + strong opioid –          (Grade D)   Epidural analgesia –          except in high-risk pulmonary patients (Grade D)
	OTHER INTERVENTIONS   Oral carbohydrate –          (Grade D)