Journal of Isfahan Medical School

Journal of Isfahan Medical School

A Comparative Study of the Effect of Local Infiltration of Hydrocortisone Dose Preemptively on Pain and Nausea and Vomiting after Laparoscopic Cholecystectomy Surgery

Document Type : Original Article(s)

Authors
Seyed Mohammad Reza Safavi 1
Azim Honarmand 1
Masood Sayadishahraki 2
Parto Derakhshandeh 3
1 Professor, Anesthesiology and Critical Care Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
2 Associated Professor of Surgery, Isfahan University of Medical Sciences, Isfahan, Iran
3 Isfahan University of Medical Sciences, Isfahan, Iran
10.48305/jims.v43.i831.1124
Abstract
Background: Laparoscopic cholecystectomy, while minimally invasive, often results in significant pain during the first 24 hours postoperatively. This study aimed to compare the preemptive local infiltration of two different doses of hydrocortisone on pain and postoperative nausea and vomiting (PONV) following this procedure.
Methods: In a triple-blind clinical trial conducted between 2021 and 2022, patients undergoing elective laparoscopic cholecystectomy at Isfahan Al-Zahra Hospital were randomly assigned to three groups: Group A received 100 mg hydrocortisone, Group B received 50 mg hydrocortisone, and Group C received 20 mL normal saline as a placebo. Pain and nausea intensity were assessed using a Visual Analog Scale (VAS) in the recovery room and for 24 hours post-surgery.
Findings: Pain intensity was significantly lower in the 100 mg hydrocortisone group compared to both the 50 mg group and the control group (P = 0.003). The control group required significantly more analgesic medication than both hydrocortisone groups (P < 0.001) and had a shorter time to first analgesic request (P < 0.001). However, no significant differences were observed among the three groups in terms of nausea severity (P = 0.40), vomiting frequency (P = 0.06), number of antiemetic doses (P = 0.06), or time to first antiemetic need (P = 0.09).
Conclusion: Preemptive local infiltration of hydrocortisone, particularly at a 100 mg dose, effectively reduces postoperative pain and analgesic requirements in patients undergoing laparoscopic cholecystectomy but does not significantly affect the incidence or severity of PONV.

Highlights

Seyed Mohammad Reza Safavi:  Google Scholar 

Azim Honarmand: Google Scholar

Masood Sayadishahraki: Google Scholar 

Keywords
Laparoscopic cholecystectomy
Hydrocortisone
Pain
Nausea
Vomiting

Subjects

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Journal of Isfahan Medical School
Volume 43, Issue 831
3rd Week November
November and December 2025
Pages 1124-1132

  • Receive Date 14 May 2025
  • Accept Date 19 July 2025