Integrated Strategies for the Management of Pain, Nausea, and Anxiety in Postoperative Recovery from Laparoscopic Cholecystectomy
Keywords:
Colecistectomia Laparoscópica, Dor Pós-Operatória, Náusea, Ansiedade, Recuperação Pós-OperatóriaAbstract
This study addresses integrated strategies for effectively managing pain, nausea, anxiety, and functional recovery after laparoscopic cholecystectomy. Pharmacological techniques such as preemptive nalbuphine and regional techniques including transverse abdominal plane (TAP) block, combined intercostal block, and erector spinae plane (ESP) block demonstrated superiority in reducing pain and analgesic consumption. Non-pharmacological strategies, including controlled hyperventilation, pulmonary recruitment, acupuncture, auriculotherapy, breathing exercises, and acupressure, also showed efficacy in reducing postoperative complications like shoulder pain and gastrointestinal symptoms. Interventions for managing preoperative anxiety, such as multimedia education and combined use of remimazolam and estazolam, provided additional benefits in gastrointestinal recovery and sleep quality. Optimizing surgical technique, with attention to gallbladder extraction site and safety-critical view techniques, reduced complications like bile duct injuries and incisional hernias. Perioperative planning that considers individual risk factors proved essential in preventing complications and enhancing clinical outcomes.
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