Shoulder Tip Pain in Laparoscopic Cholecystectomy with Active vs Passive Evacuation of Pneumoperitoneum

Abstract

Objective: The objective of the study was to compare the frequency of severity of shoulder tip pain after active (gas suctioning) and passive removal of pneumoperitoneum among patient undergoing laparoscopic cholecystectomy. Methods: This Observational comparative study was directed in general surgery department of DOW university hospital beginning from February 2016 to February 2017. Two hundred and six patients undergoing standard 4 port laparoscopic cholecystectomy were enrolled equally in either groups. The surgeon evacuated the abdomen by using a multiporous suction tube limiting the negative suction pressure to - 40 mmHg for 2-5 minutes under direct vision in active aspiration group, while in control group, CO2 was removed passively. Pain scores were recorded using visual analog score at 16 hours post-operatively by residents of surgery blinded to the study. Results: Mean VAS pain score at 16 hours in intervention group was much inferior than control group 1.00 ±2.09 vs. 3.06 ± 2.58 ( p < 0.001). Conclusion: Active aspiration of CO2 is an effective method that removes most if not all gas from the abdominal cavity. This will cause statistically significant decrease post-operative discomfort, pain and decrease need of rescue analgesics. Key Words: Laparoscopic cholecystectomy, Pneumoperitoneum, Active Aspiration, shoulder tip pain, post- laproscopic cholecystectomy pain How to Cite: Arif A, Nofal S, Khan MA, Khan AW, Bhatti AM, Ishaq SH. Shoulder tip pain in laparoscopic cholecystectomy with active vs passive evacuation of pneumoperitoneum. Esculapio. 2020;16(04):116-119.