Opioids are the corner stone in the treatment of post operative pain. Because of the several
side effects of opiods, non-steroidal anti-inflammatory drugs are usually added
postoperatively to decrease the total requirements of opioids. However, non steroidal
anti-inflammatory drugs have side effects of their own. Vitamin C, with virtually no side
effects when used on short-term basis, has been shown to have promising analgesic effects in
chronic pain and acute pain relief following orthopedic surgeries.
The investigators propose to assess the role of a prophylactic single dose (2g) of vitamin C
in reducing the intensity of pain and the consumption of opioids in patients undergoing
laparoscopic cholecystectomy at AUB-MC.
All eligible patients undergoing laparoscopic cholecystectomy at AUB-MC will be included in
the study. Patients will be randomized into two groups to receive either single dose oral
vitamin C (2g) (Study Group) or identically looking placebo capsules (Control Group). Both
the patients and the investigation team will be blinded to the type of intervention.
Intraoperative anesthesia management will be similar for both groups. Postoperative pain
control will be achieved with patient controlled analgesia via a patient controlled morphine
pump in both groups. At several time intervals and up to 24 hours postoperatively, the pain
scores, morphine consumptions, nausea/vomiting scores, sedation scales, itching scales, and
patient satisfaction scales will be obtained for all patients. Also, the peak vitamin C
concentration will be determined for each patient.
Patients demographics will be obtained and compared between both groups. The differences in
pain scores, morphine consumptions, nausea/vomiting scores, and sedation, itching, and
patient satisfaction scales will be compared between the two groups with the Student-t test,
the analysis of variance, the Fisher exact test, and the Kruskal-Wallis test. The peak
vitamin C plasma concentration will be correlated with the pain scores in each group using
This study will provide relevant information on whether a single dose (2g) of vitamin C can
reduce morphine requirements and non steroidal anti-inflammatory drugs need and thus
eliminating their side effects in patients undergoing laparoscopic cholecystectomy.