Intraperitoneal Granisetron for Post‐Laparoscopic Cholecystectomy Pain Management: A Double‐Blinded, Randomized Controlled Trial

Abstract

BACKGROUND: Laparoscopic cholecystectomy (LC) may cause significant pain, increasing morbidity. Granisetron, an antiemetic selective serotonin (5HT3)-antagonist, demonstrates analgesic properties through sodium channel blockade. The current study aims to assess the efficacy of adjuvant intraperitoneal granisetron in post-LC pain. RESEARCH DESIGN AND METHODS: In this prospective randomized controlled trial, 48 patients undergoing LC were randomized into placebo (intraperitoneal saline) and intervention (intraperitoneal granisetron) groups. Pain intensity was measured via visual analog scale (VAS) at 2-, 4-, 8-, 12-, and 24-h post-surgery, with comparative analysis of the area under the curve (AUC) of the 24-h VAS scores. Additional outcomes included sedation levels, persistent pain incidence, quality of life improvement, postoperative nausea and vomiting (PONV), time to first rescue analgesic request, total analgesic consumption, and independent mobilization. RESULTS: The treatment group showed significantly lower VAS at 8, 12, and 24 h (p = 0.039, 0.004, 0.030) and lower VAS score AUC (542.7 ± 260.5 vs. 767.1 ± 317.8, p = 0.011) compared to controls, respectively. No significant differences were observed in (2-4 h) pain scores, persistent pain incidence, quality of life, sedation levels, PONV, analgesic requirements, or mobilization time (p < 0.05). CONCLUSIONS: Granisetron could improve multimodal pain control after LC, offering better outcomes while maintaining its established safety profile. TRIAL REGISTRATION: NCT06281418.