Faculty Advisor(s)

Elisha Coppens

Document Type


Publication Date

Spring 2023


© 2023 the Author


As the understanding of opioid dependence mechanisms and origins in the adult population continues to evolve in the United States, so does the pursuit of alternative avenues for analgesia. Many opioid substance-use disorder patients can trace the origins of their dependence to routine prescription and administration of opioids during surgical procedures (Bohringer et al., 2020). One such procedure where opioids are frequently utilized for intraoperative and postoperative analgesia is laparoscopic cholecystectomy. Incidence of gall bladder disease is closely related to obesity (Hines & Marschall, 2018). Gallstone disease continues to be a common and costly health problem affecting 10 to 20% of the US adult populations (NIH, 2023). The definitive treatment for acute cholecystitis is removal of the gall bladder commonly performed utilizing the laparoscopic technique (Hines & Marschall, 2018).

Does the use of intraoperative esmolol versus ketamine infusion in adult patients undergoing laparoscopic cholecystectomy surgery improve postoperative pain? This literature review sought to better understand the role of two non-opioid adjuncts, esmolol and ketamine, in postoperative pain for adults undergoing laparoscopic cholecystectomy. When measured in terms of pain intensity and opioid consumption postoperative nociception was improved with intraoperative esmolol and ketamine compared opioids and other non-opioid adjuncts.


MSNA Capstone



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