Comparison of Impacts of Intraperitoneal Saline Instillation with and without Pulmonary Recruitment Maneuver on Post-Laparoscopic Shoulder Pain Prevention: A Randomized Controlled Trial

Abstract

Objective: The most plausible mechanism of post-laparoscopic shoulder pain (PLSP) is the referred pain to the shoulder by retained carbon dioxide in the peritoneal cavity. Intraperitoneal isotonic saline instillation (SI) and pulmonary recruitment maneuver (RM) were indicated to alleviate PLSP effectively. However, as SI and RM act through a similar mechanism of removing residual carbon dioxide from the peritoneal cavity, it is debatable whether the combined use of both interventions is superior to using either of them individually in reducing PLSP. This study was designed to compare the single strategy using SI alone with the combined strategy using SI and RM.