Maxigesic for Postoperative Pain Control After Laparoscopic or Robotic Gastrectomy

Postoperative pain management is an important component of recovery after gastrectomy.Opioids are commonly used for the treatment of acute postoperative pain; however,opioid‐related adverse effects and concerns regarding excessive opioid exposure haveincreased interest in multimodal analgesic strategies that combine non‐opioid analgesics.Maxigesic is an intravenous fixed‐dose combination of acetaminophen 1,000 mg andibuprofen 300 mg. This study is designed to evaluate whether perioperative administrationof Maxigesic provides effective postoperative analgesia and reduces the need for opioidand rescue analgesics compared with intravenous acetaminophen alone in patientsundergoing minimally invasive gastrectomy for gastric cancer.A total of 90 adult participants scheduled to undergo laparoscopic or robotic gastrectomywill be randomly assigned in a 1:1 ratio to the Maxigesic group or the acetaminophencontrol group. Participants assigned to the Maxigesic group will receive intravenousMaxigesic at the initiation of anesthesia and subsequently at 6‐hour intervals aftersurgery through 72 hours after surgery. Participants assigned to the control group willreceive intravenous acetaminophen 1,000 mg at 6‐hour intervals according to thepostoperative analgesic protocol. Postoperative patient‐controlled analgesia containingfentanyl will be available, and additional rescue analgesics may be administered asclinically indicated.Postoperative pain intensity will be assessed using the Numeric Rating Scale (NRS)immediately after surgery and at 12, 24, 48, and 72 hours after surgery. The primaryefficacy outcome is the sum of pain intensity differences over the first 72 postoperativehours (SPID72). Secondary efficacy outcomes include NRS pain scores at predefinedpostoperative time points, total opioid consumption during the first 48 hours, the numberof rescue analgesic administrations during the first 48 hours, and the use of antiemeticmedications during the first 48 hours. Safety will be evaluated through the assessment ofadverse events until postoperative day 5 or hospital discharge.