Evaluating the effect of gentamicin-clindamycin lavage on post-operational pain and infection through laparoscopic colectomy surgery

Journal of Coloproctology - Tập 40 - Trang 8-11 - 2020
Alireza Negahi1, Amirhossein Arminfar2, Hamed Vaseghi2, Mohammad Moradi3, Mahdi Alemrajabi4
1Iran University of Medical Sciences, Rasool Akram Hospital, Department of General Surgery, Tehran, Iran
2Iran University of Medical Sciences, Tehran, Iran
3Iran University of Medical Sciences, Firoozgar Clinical Research Development Center, Tehran, Iran
4Iran University of Medical Sciences, Firoozgar Clinical Research Development Center, Firoozgar Hospital, Tehran, Iran

Tóm tắt

Abstract Introduction Peritoneal antibiotic or normal saline lavage is seen to be beneficial in order to reduce the pain or infection risk through laparoscopic surgeries. It can also be applied for laparoscopic colectomy surgeries. In this study, we have compared the effects of antibiotic solution lavage (gentamycin-clindamycin) with normal saline lavage in patients undergoing laparoscopic colectomy surgery. Method In this double-blind Randomized Controlled Trial (RCT), 40 patients undergoing laparoscopic colectomy surgery were divided into antibiotic and normal saline lavage groups (20 patients in each group). Post-operational pain, need for painkiller, white blood cells count, C-reactive protein level, duration of hospitalization and wound infection were compared in 30 days between the groups. Results Antibiotic lavage group had significantly less pain than the normal saline group (p < 0.05) through 3, 6, 12 and 24 h after surgery. C-reactive protein level, white blood cells count, painkiller use, and hospitalization duration were significantly lower in antibiotic group. However, there was no difference regarding wound or intra-abdominal infection between the both groups. Conclusion Using gentamicin-clindamycin peritonea lavage helps patients undergoing laparoscopic colectomy surgery in pain reduction, need for painkillers and hospitalization duration.

Tài liệu tham khảo

Qadan, 2010, Meta-analysis of the effect of peritoneal lavage on survival in experimental peritonitis, Br J Surg, 97, 151, 10.1002/bjs.6906 Edmiston, 2016, Intra-operative surgical irrigation of the surgical incision: what does the future hold-saline, antibiotic agents, or antiseptic agents?, Surg Infect (Larchmt), 17, 656, 10.1089/sur.2016.158 Whiteside, 2005, Intra-operative peritoneal lavage ‒ who does it and why?, Ann R Coll Surg Engl, 87, 255, 10.1308/1478708051847 Platell, 2000, The influence of lavage on peritonitis, J Am Coll Surg, 191, 672, 10.1016/S1072-7515(00)00726-2 Jergens, 1977, Peritoneal lavage, Am J Surg, 133, 365, 10.1016/0002-9610(77)90546-3 Adam, 1997, Programmed lavage as a basic principle in therapy of diffuse peritonitis, Langenbecks Arch Chir, 382, S18, 10.1007/PL00014638 Ruiz-Tovar, 2016, Effect of peritoneal lavage with clindamycin-gentamicin solution during elective colorectal cancer surgery on the oncologic outcome, Surg Infect (Larchmt), 17, 65, 10.1089/sur.2015.064 Oller, 2015, Effect of lavage with gentamicin vs. clindamycin vs. physiologic saline on drainage discharge of the axillary surgical bed after lymph node dissection, Surg Infect (Larchmt), 16, 781, 10.1089/sur.2015.020 Ruiz-Tovar, 2012, Effect of peritoneal lavage with clindamycin-gentamicin solution on infections after elective colorectal cancer surgery, J Am Coll Surg, 214, 202, 10.1016/j.jamcollsurg.2011.10.014 Ruiz-Tovar, 2016, Effect of peritoneal lavage with clindamycin-gentamicin solution on post-operative pain and analytic acute-phase reactants after laparoscopic sleeve gastrectomy, Surg Infect (Larchmt), 17, 357, 10.1089/sur.2015.196 Briggs, 2017, Tips, tricks, and technique for laparoscopic colectomy, Clin Colon Rectal Surg, 30, 130, 10.1055/s-0036-1597313 Simon, 2004, Serum procalcitonin and C-reactive protein levels as markers of bacterial infection: a systematic review and meta-analysis, Clin Infect Dis, 39, 206, 10.1086/421997 Park, 2011, The effect of intraperitoneal ropivacaine on pain after laparoscopic colectomy: a prospective randomized controlled trial, J Surg Res, 171, 94, 10.1016/j.jss.2010.03.024 Ruiz-Tovar, 2013, Effect of gentamicin lavage of the axillary surgical bed after lymph node dissection on drainage discharge volume, Breast, 22, 874, 10.1016/j.breast.2013.03.008 Baker, 1994, Taurolidine peritoneal lavage as prophylaxis against infection after elective colorectal surgery, Br J Surg, 81, 1054, 10.1002/bjs.1800810743 Kotake, 2001, Subclinical hepatic dysfunction in laparoscopic cholecystectomy and laparoscopic colectomy, Br J Anaesth, 87, 774, 10.1093/bja/87.5.774
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Journal of Coloproctology

Tập 40

8-11

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