• Amin Mohamed Alansary and Marwa Ahmed Khairy Elbeialy.
• Department of Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Ain-Shams University, Cairo, Egypt.
• Clin J Pain. 2024 Mar 7.

ObjectivesAripiprazole is a second-generation atypical antipsychotic with worldwide clinical approval. Nevertheless, its perioperative antinociceptive application has not been studied. As a result, the purpose of this study was to investigate the analgesic effects of perioperative aripiprazole on reducing postoperative pain, as well as the possible adverse effects.MethodsThis randomized controlled study enrolled eighty female patients scheduled for laparoscopic hysterectomy who were assigned randomly into two equal groups in 1:1; Aripiprazole group (n=40): patients received an aripiprazole 30 mg tablet orally three hours before surgery, and Placebo group (n=40): patients received a placebo tablet three hours before surgery. The 24-hour morphine consumption postoperatively was the primary outcome, and the time to the first analgesic request, sedation scores, and the incidence of perioperative adverse events were the secondary outcomes.ResultsThe mean 24-hour morphine consumption was significantly lower with aripiprazole (2.5±0.5 mg) than with placebo (23.7±1.6 mg) (Mean±SE -21.2±0.3, 95% CI: -21.7 to -20.6, P<0.001). In addition, mean time to the first analgesic request was significantly longer with aripiprazole (212.2±14.7 min) than with placebo (27.0±2.0 min) (Mean±SE 185.2±2.3, 95% CI: 180.5 to 189.8, P<0.001). Furthermore, aripiprazole group reported higher sedation scores (P<0.001). Bradycardia and hypotension were reported more frequently among patients in the aripiprazole group (P<0.05).DiscussionAripiprazole was effective in reducing pain following laparoscopic hysterectomy. Although self-limited, side effects should be taken into consideration when using the medication perioperatively.Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.

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