A FOLLOW-UP STUDY - LOW-PRESSURE PNEUMOPERITONEUM COMPARED TO STANDARD PNEUMOPERITONEUM IN LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Introduction-: Post-laparoscopic pain syndrome is well conceded and characterized by abdominal and especially shoulder tip pain. It occurs frequently following laparoscopic cholecystectomy. The etiology of post-laparoscopic pain can be classied into three aspects visceral, incision, and shoulder. This study purposed to compare the frequency and strength of shoulder tip pain between low pressure (7 mmHg) and standard pressure (14 mmHg) in a prospective randomized clinical test. Methods-: One hundred forty successive patients undergoing elective laparoscopic cholecystectomy were randomized prospectively to either low or high-pressure pneumoperitoneum. The statistical analysis included mean age, weight, sex, duration of surgery, conversion rate, American Society of Anesthesiologists (ASA) grade, operative time, incidence and severity of shoulder tip pain, and post-operative hospital stay. Results -: The patient's quality was similar in the two groups except for the predominance of males in the standard-pressure group. The plan of action was successful in 68 of 70 patients in the low-pressure group. The number of analgesic injections, visual analog score, operative time, and length of post-operative days were the same in all groups. Occurence of shoulder tip pain was higher in the standard-pressure group, but not statistically signicantly so (p = 0.100) (27.9% versus 44.3%). Conclusions -: Low-pressure pneumoperitoneum tended to be better than standard-pressure pneumoperitoneum in a period of lower incidence of shoulder tip pain. Still, this difference did not reach statistical signicance following elective laparoscopic cholecystectomy