INCIDENCE OF SHOULDER-TIP PAIN IN LAP. CHOLECYSTECTOMY NORMAL VERSUS LOW-PRESSURE PNEUMOPERITONEUM
DOI:
https://doi.org/10.54112/bcsrj.v2023i1.486Keywords:
Post-op shoulder-tip pain, Low-pressure pneumoperitoneum, standard pressure peritoneum, Post-op analgesia demandAbstract
Open cholecystectomy can lead to several post-operative complications. However, with the advent of minimal access surgery, these complications have decreased to a large extent. Nowadays, laparoscopic cholecystectomy is considered the gold standard for cholelithiasis. Similar to other surgeries, some post-operative complications are linked to laparoscopic surgery. One such complication is shoulder-tip pain. This study aimed to compare the intensity of post-op shoulder-tip pain after laparoscopic cholecystectomy at low pressure (10mmHg or less than 10mmHg) and standard pressure (12-14mmHg). Two groups of 30 patients each were made in this prospective randomized study. Group A patients underwent low-pressure pneumoperitoneum cholecystectomy (10mmHg or less than 10mmHg), while group B underwent standard-pressure pneumoperitoneum cholecystectomy (12-15mmHg). According to the verbal pain intensity score, post-op shoulder-tip pain was reduced in Group A compared to Group B at 6, 12, and 24 postoperative hours. This study showed that using low-pressure pneumoperitoneum in laparoscopic cholecystectomy reduces the intensity of post-operative shoulder pain and the need for analgesia.
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References
Barczyński, M., and Herman, R. (2004). Low-pressure pneumoperitoneum combined with intraperitoneal saline washout for reduction of pain after laparoscopic cholecystectomy: a prospective randomized study. Surgical Endoscopy and Other Interventional Techniques 18, 1368-1373.
Barczyński, M., and Herman, R. M. (2002). The usefulness of low-pressure pneumoperitoneum in laparoscopic surgery. Folia Medica Cracoviensia 43, 43-50.
Chok, K. S., Yuen, W. K., Lau, H., and Fan, S. T. (2006). Prospective randomized trial on low-pressure versus standard-pressure pneumoperitoneum in outpatient laparoscopic cholecystectomy. Surgical Laparoscopy Endoscopy & Percutaneous Techniques 16, 383-386.
Dexter, S., Vucevic, M., Gibson, J., and McMahon, M. (1995). Preservation of hemodynamic function by low pressure laparoscopic cholecystectomy. Surg Endosc 9, 600.
Donatsky, A. M., Bjerrum, F., and Gögenur, I. (2013). Surgical techniques to minimize shoulder pain after laparoscopic cholecystectomy. A systematic review. Surgical endoscopy 27, 2275-2282.
Gurusamy, K. S., Vaughan, J., and Davidson, B. R. (2014). Low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy. Cochrane Database of Systematic Reviews.
Haribhakti, S. P., and Mistry, J. H. (2015). Techniques of laparoscopic cholecystectomy: Nomenclature and selection. Journal of minimal access surgery 11, 113.
Kandil, T. S., and Hefnawy, E. E. (2010). Shoulder pain following laparoscopic cholecystectomy: factors affecting the incidence and severity. Journal of Laparoendoscopic & Advanced Surgical Techniques 20, 677-682.
Kanwer, D. B., Kaman, L., Nedounsejiane, M., Medhi, B., Verma, G. R., and Bala, I. (2010). Comparative study of low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy-a randomised controlled trial. Tropical Gastroenterology 30, 171-174.
Koc, M., Ertan, T., Tez, M., Kocpinar, M. A., Kilic, M., Gocmen, E., and Aslar, A. K. (2005). Randomized, prospective comparison of postoperative pain in low‐versus high‐pressure pneumoperitoneum. ANZ journal of surgery 75, 693-696.
McSherry, C. K. (1989). Cholecystectomy: the gold standard. The American journal of surgery 158, 174-178.
Perrakis, E., Vezakis, A., Velimezis, G., Savanis, G., Deverakis, S., Antoniades, J., and Sagkana, E. (2003). Randomized comparison between different insufflation pressures for laparoscopic cholecystectomy. Surgical Laparoscopy Endoscopy & Percutaneous Techniques 13, 245-249.
Rosenthal, R. J., Friedman, R. L., Kahn, A. M., Martz, J., Thiagarajah, S., Cohen, D., Shi, Q., and Nussbaum, M. (1998). Reasons for intracranial hypertension and hemodynamic instability during acute elevations of intra-abdominal pressure: observations in a large animal model. Journal of Gastrointestinal Surgery 2, 415-425.
Sandhu, T., Yamada, S., Ariyakachon, V., Chakrabandhu, T., Chongruksut, W., and Ko-Iam, W. (2009). Low-pressure pneumoperitoneum versus standard pneumoperitoneum in laparoscopic cholecystectomy, a prospective randomized clinical trial. Surgical endoscopy 23, 1044-1047.
Sandoval-Jiménez, C., Méndez-Sashida, G., Cruz-Márquez-Rico, L., Cárdenas-Victorica, R., Guzmán-Esquivel, H., Luna-Silva, M., and Díaz-Valero, R. (2009). Postoperative pain in patients undergoing elective laparoscopic cholecystectomy with low versus standard-pressure pneumoperitoneum. A randomized clinical trial. Revista de Gastroenterologia de Mexico 74, 314-320.
Sarli, L., Costi, R., Sansebastiano, G., Trivelli, M., and Roncoroni, L. (2000). Prospective randomized trial of low-pressure pneumoperitoneum for reduction of shoulder-tip pain following laparoscopy. Journal of British Surgery 87, 1161-1165.
Semm, K., and Riedel, H. (1980). Das postpelviskopische (laparoskopische) schmerzsyndrom. Gerburtshilfe Fraueheilk 40, 635-643.
Wallace, D., Serpell, M., Baxter, J., and O'dwyer, P. (1997). Randomized trial of different insufflation pressures for laparoscopic cholecystectomy. British journal of surgery 84, 455-458.
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