Effect of vitamin C on morphine use after laparoscopic cholecystectomy: a randomized controlled trial

We designed a randomized double-blind placebo-controlled trial to assess the role of a single prophylactic dose of vitamin C (2 g) in reducing the consumption of opioids postoperatively in patients undergoing laparoscopic cholecystectomy. Eighty adult patients were allocated to receive 2 g vitamin C or placebo approximately one hour prior to induction of anesthesia. Following laparoscopic cholecystectomy, patients received morphine patient-controlled analgesia for 24 hr. The following data were assessed postoperatively in the postanesthesia care unit at two, four, six, 12, and 24 hr: morphine consumption, verbal numerical rating scale scores for incisional pain and nausea/vomiting, and pruritus and sedation scores. The primary outcome measure was 24-hr morphine consumption. Patient satisfaction was assessed before hospital discharge. Morphine consumption was significantly lower in the vitamin C group the placebo group [16.2 (10.7) and 22.8 (13.8) mg, respectively; difference = 6.6 mg; 95% confidence interval, 1.1 to 12.1 mg; = 0.02]. There was no difference in pain scores or side effects between the two groups. Satisfaction scores were similar in both groups. Our study showed that supplementation with vitamin C (2 g) decreased morphine consumption in the postoperative period in patients undergoing laparoscopic cholecystectomy. (ClinicalTrials.gov number, NCT01322061).