{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T17:22:43Z","timestamp":1779211363573,"version":"3.51.4"},"reference-count":46,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,2,27]],"date-time":"2014-02-27T00:00:00Z","timestamp":1393459200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pain Practice"],"published-print":{"date-parts":[[2015,4]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The main purpose of the study was to test whether the combination of gabapentin (600\u00a0mg 4\u00a0hours before surgery, 600\u00a0mg after 24\u00a0hours), ketamine (0.3\u00a0mg\/kg before anesthesia), lornoxicam (8\u00a0mg before anesthesia and 8\u00a0mg\/12\u00a0hours), and local ropivacaine (5\u00a0mL 7.5% at insertion sites) provides superior analgesia to each of these drugs alone in the first 24\u00a0hours after laparoscopic cholecystectomy. The secondary purpose was to examine whether this combination has less opioid\u2010related side effects.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This was a 2\u2010center randomized placebo\u2010controlled trial. One hundred forty\u2010eight patients, between 18 and 70\u00a0years of age, were randomly assigned to 6 groups (28 in each group) with the use of computer software: A(gabapentin\/ketamine\/lornoxicam\/ropivacaine); B(gabapentin\/placebo\/placebo\/placebo); C (placebo\/ketamine\/placebo\/placebo); D (placebo\/placebo\/lornoxicam\/placebo); E (placebo\/placebo\/placebo\/ropivacaine); and F (placebo\/placebo\/placebo\/placebo). Only the principal investigator was aware of patients' allocation and provided drugs and placebo in covered prefilled syringes. The primary outcome of the study was the 24\u2010hour morphine consumption. Secondary outcomes were frequency of opioid\u2010related side effects (nausea, vomiting, sedation, pruritus, and dysuria).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Only groups A (6.4\u00a0mg), B (9.46\u00a0mg), and D (9.36\u00a0mg) had lower morphine consumption than control group (20.29\u00a0mg) (<jats:italic>P<\/jats:italic>\u00a0&lt;\u00a00.001, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.01, and <jats:italic>P<\/jats:italic>\u00a0=\u00a00.008, respectively). Group A was not different from B and D (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.92, <jats:italic>P<\/jats:italic>\u00a0=\u00a00.93). The only difference was in episodes of nausea between groups A (<jats:italic>n<\/jats:italic>\u00a0=\u00a05) and the control group (<jats:italic>n<\/jats:italic>\u00a0=\u00a012) (<jats:italic>P<\/jats:italic>\u00a0=\u00a00.018).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The combination of gabapentin, ketamine, lornoxicam, and local ropivacaine does not provide superior analgesia than gabapentin alone or lornoxicam alone after laparoscopic cholecystectomy. The combination reduces only the frequency of postoperative nausea, but larger studies are needed for safer results.<\/jats:p><\/jats:sec>","DOI":"10.1111\/papr.12183","type":"journal-article","created":{"date-parts":[[2014,2,27]],"date-time":"2014-02-27T07:53:00Z","timestamp":1393487580000},"page":"355-363","source":"Crossref","is-referenced-by-count":13,"title":["Comparison between the Combination of Gabapentin, Ketamine, Lornoxicam, and Local Ropivacaine and Each of these Drugs Alone for Pain after Laparoscopic Cholecystectomy: A Randomized Trial"],"prefix":"10.1111","volume":"15","author":[{"given":"Georgios","family":"Kotsovolis","sequence":"first","affiliation":[{"name":"Department of Anesthesia and Intensive Care 424 Military Hospital of Thessaloniki Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Konstantinos","family":"Karakoulas","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care AHEPA University Hospital Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasileios","family":"Grosomanidis","sequence":"additional","affiliation":[{"name":"Department of Anesthesia and Intensive Care AHEPA University Hospital Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nikolaos","family":"Tziris","sequence":"additional","affiliation":[{"name":"3rd Department of Surgery AHEPA University Hospital Thessaloniki Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2014,2,27]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ane.0000255040.71600.41"},{"key":"e_1_2_7_3_1","first-page":"2729","volume-title":"Miller's Anesthesia","author":"Wu CL","year":"2005"},{"key":"e_1_2_7_4_1","article-title":"APM:SE Working Group of the Australian and New Zealand College of Anaesthetists and Faculty of Pain Medicine","author":"Macintyre PE","year":"2010","journal-title":"Acute Pain Management: Scientific Evidence"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000539-199709000-00008"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200001000-00038"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2006.11.003"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pain.2011.03.013"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/aei038"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/bja\/87.1.88"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(06)68700-X"},{"key":"e_1_2_7_12_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200010000-00038"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1097\/ACO.0b013e328330373a"},{"key":"e_1_2_7_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0952-8180(01)00320-8"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.bpa.2006.12.003"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1213\/00000539-199311000-00030"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-9610(02)00866-8"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200506000-00027"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.1213\/01.ANE.0000118109.12855.07"},{"key":"e_1_2_7_20_1","first-page":"76","article-title":"Multimodal analgesia: its role in preventing postoperative pain. 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