Laparoscopic Cholecystectomy Medication

Updated: Apr 16, 2020
  • Author: Danny A Sherwinter, MD; Chief Editor: Kurt E Roberts, MD  more...
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Medication

Medication Summary

The goals of pharmacotherapy are to reduce morbidity and prevent complications.

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Local Anesthetics

Class Summary

Local anesthetic agents are used to increase patient comfort during the procedure.

Lidocaine and epinephrine (Lignospan Forte, Xylocaine with Epinephrine)

Lidocaine is an amide local anesthetic used in a 0.5-1% concentration in combination with bupivacaine (50:50 mixture). This agent inhibits depolarization of type C sensory neurons by blocking sodium channels. Epinephrine prolongs the duration of the anesthetic effects from lidocaine by causing vasoconstriction of the blood vessels surrounding the nerve axons.

Bupivacaine (Marcaine, Sensorcaine)

Bupivacaine 0.25% may be used in combination with lidocaine plus epinephrine (50:50 mixture). It decreases permeability to sodium ions in neuronal membranes. This results in the inhibition of depolarization, blocking the transmission of nerve impulses.

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General Anesthetics

Class Summary

After standard monitoring equipment is attached and peripheral venous access achieved but before the arterial line is inserted, the midazolam or lorazepam dose is administered.

Propofol (Diprivan, Fresenius Propoven)

Propofol is a phenolic compound unrelated to other types of anticonvulsants. It has general anesthetic properties when administered intravenously. Intravenous propofol produces rapid hypnosis, usually within 40 seconds. The effects are reversed within 30 minutes, following the discontinuation of infusion. Propofol has also been shown to have anticonvulsant properties.

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Antibiotics

Class Summary

Typically, a single dose of a cephalosporin is administered by the anesthesiologist before the skin incision.

Cefazolin

Cefazolin is a first-generation semisynthetic cephalosporin that arrests bacterial cell wall synthesis, inhibiting bacterial growth. It is used for infections caused by gram-positive cocci (except enterococci)

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Analgesics

Class Summary

Pain control is essential to quality patient care. It ensures patient comfort, promotes pulmonary toilet, and aids physical therapy regimens. Many analgesics have sedating properties that benefit patients who experience moderate to severe pain.

Acetaminophen and codeine (Tylenol #3)

This combination is indicated for mild to moderate pain.

Acetaminophen (Tylenol, Aspirin-Free Anacin, Cetafen, Mapap Extra Strength)

Acetaminophen is the drug of choice for the treatment of pain in patients with documented hypersensitivity to aspirin or NSAIDs, as well as in those with upper GI disease or who are taking oral anticoagulants.

Hydrocodone bitartrate and acetaminophen (Vicodin ES, Lortab, Lorcet Plus, Norco, Maxidone)

This agent is indicated for the relief of moderately severe to severe pain.

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