دوره 31، شماره 146 - ( 4-1402 )                   جلد 31 شماره 146 صفحات 229-221 | برگشت به فهرست نسخه ها


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Imani B, Nejati H, Sepidkar A, Talebi-Ghane E. The Effect of Low-Pressure Pneumoperitoneum with Active Evacuation on the Severity of Shoulder Pain in Patients Undergoing Laparoscopic Cholecystectomy. J Adv Med Biomed Res 2023; 31 (146) :221-229
URL: http://journal.zums.ac.ir/article-1-6855-fa.html
The Effect of Low-Pressure Pneumoperitoneum with Active Evacuation on the Severity of Shoulder Pain in Patients Undergoing Laparoscopic Cholecystectomy. Journal of Advances in Medical and Biomedical Research. 1402; 31 (146) :221-229

URL: http://journal.zums.ac.ir/article-1-6855-fa.html


چکیده:   (3331 مشاهده)

Background and Objective: Although the pain severity following laparoscopic cholecystectomy is generally lower compared to the open method, but some patients may still experience abdominal and shoulder pain for several days after the laparoscopic procedure. Based on recent evidences, pneumoperitoneum using low-pressure carbon dioxide gas can reduce the pain. This study evaluated the feedback on shoulder pain severity from laparoscopic cholecystectomy patients experiencing CO2-pneumoperitoneum.
Materials and Methods: 80 laparoscopic cholecystectomy cases were allocated for intervention (n = 40) and control groups (n = 40) randomly. Pneumoperitoneum was done by a direct trocar. Patients’ pain feedback was assessed using the visual pain scale after the surgery. SPSS 21 was used to analyze the collected data.
Results: Shoulder pain frequency significantly differed between the two groups at 12 hours (P = 0.048) and 24 hours (P = 0.001) after the surgery. Regarding average shoulder pain severity, the groups showed significant differences after 2, 6, and 24 hours of surgery (P < 0.05). Moreover, pneumoperitoneum duration was different in the groups (P = 0.001).
Conclusion: Based on these findings, low pressure of pneumoperitoneum with active evacuation compared to the standard pressure, efficiently reduced shoulder pain intensity. Thus, using low-pressure pneumoperitoneum in laparoscopic cholecystectomy is recommended to relieve postoperative pain.

متن کامل [PDF 423 kb]   (1716 دریافت)    
نوع مطالعه: کارآزمایی بالینی | موضوع مقاله: Clinical Medicine
دریافت: 1401/6/25 | پذیرش: 1402/1/6 | انتشار: 1402/4/5

فهرست منابع
1. Kapoor T, Wrenn SM, Callas PW, Abu-Jaish W. Cost analysis and supply utilization of laparoscopic cholecystectomy. Minim Invasive Surg. 2018;2018:7838103. [DOI:10.1155/2018/7838103] [PMID] [PMCID]
2. Strasberg SM. Tokyo guidelines for the diagnosis of acute cholecystitis. J Am Coll Surg. 2018;227(6):624. [DOI:10.1016/j.jamcollsurg.2018.09.005] [PMID]
3. Lammert F, Acalovschi M, Ercolani G, et al. EASL clinical practice guidelines on the prevention, diagnosis and treatment of gallstones. J Hepatol. 2016;65(1):146-81. [DOI:10.1016/j.jhep.2016.03.005] [PMID]
4. Khanna A, Sezen E, Barlow A, Rayt H, Finch JG. Randomized clinical trial of a simple pulmonary recruitment manoeuvre to reduce pain after laparoscopy. Br J Surg. 2013;100(10):1290-4. [DOI:10.1002/bjs.9202] [PMID]
5. Sabzi Sarvestani A, Zamiri M. Residual pneumoperitoneum volume and postlaparoscopic cholecystectomy pain. Anesthesiol Pain Med. 2014;4(4):e17366. [DOI:10.5812/aapm.17366]
6. Sheffield KM, Ramos KE, Djukom CD, et al. Implementation of a critical pathway for complicated gallstone disease: Translation of population-based data into clinical practice. J Am Coll Surg. 2011;212(5):835-43. [DOI:10.1016/j.jamcollsurg.2010.12.047] [PMID] [PMCID]
7. Duncan CB, Riall TS. Evidence-based current surgical practice: Calculous gallbladder disease. J Gastrointest Surg. 2012;16(11):2011-25. [DOI:10.1007/s11605-012-2024-1] [PMID] [PMCID]
8. Schietroma M, Carlei F, Cecilia EM, et al. A prospective randomized study of systemic inflammation and immune response after laparoscopic Nissen fundoplication performed with standard and low-pressure pneumoperitoneum. Surg Laparosc Endosc Percutaneous Tech. 2013;23(2):189-96. [DOI:10.1097/SLE.0b013e3182827e51] [PMID]
9. Al-Abbadi H. Effect of laparoscopic cholecystectomy on liver enzymes in Arabian goats. J Pre-Clinical Clin Res. 2019 Mar 21;13(1):5-8. [DOI:10.26444/jpccr/103430]
10. Donatsky AM, Bjerrum F, Gögenur I. Intraperitoneal instillation of saline and local anesthesia for prevention of shoulder pain after laparoscopic cholecystectomy: A systematic review. Surg Endosc. 2013;27(7):2283-92. [DOI:10.1007/s00464-012-2759-5] [PMID]
11. Neogi P, Kumar P, Kumar S. Low-pressure pneumoperitoneum in laparoscopic cholecystectomy: A randomized controlled trial. Surg Laparosc Endosc Percutaneous Tech. 2020;30(1):30-4. [DOI:10.1097/SLE.0000000000000719] [PMID]
12. Jasim M. S, Issam M, Salam N. A. Effect of active gas suctioning to decrease the residual co[2] for preventing post-laparoscopic cholecystectomy shoulder pain. J Arab Board Heal Spec. 2013;14(2):2-8.
13. Tripathi V, Marak DAB, ResenRajan S, et al. A comparative study between the low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy. Medicine (Baltimore). 2020;9(7):1-10.
14. Valencia C, Fillingim RB, Bishop M, et al. Investigation of central pain processing in postoperative shoulder pain and disability. Clin J Pain. 2014;30(9):775-86. [DOI:10.1097/AJP.0000000000000029] [PMID] [PMCID]
15. Kanwer DB, Kaman L, Nedounsejiane M, Medhi B, Verma GR, Bala I. Comparative study of low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy--a randomised controlled trial. Trop Gastroenterol. 2009;30(3):171-4.
16. Song T, Kim KH, Lee KW. The intensity of postlaparoscopic shoulder pain is positively correlated with the amount of residual pneumoperitoneum. J Minim Invasive Gynecol. 2017;24(6):984-989. [DOI:10.1016/j.jmig.2017.06.002] [PMID]
17. Sammour T, Mittal A, Loveday BPT, Kahokehr A, Phillips ARJ, Windsor JA, et al. Systematic review of oxidative stress associated with pneumoperitoneum. Br J Surg. 2009;96(8):836-50. [DOI:10.1002/bjs.6651] [PMID]
18. Suzuki Y, Yamamoto H, Nishida K. Standing position relieved the shoulder pain caused by subdiaphragmatic drain after laparoscopic surgery. BMJ Case Rep. 2022;15(3). [DOI:10.1136/bcr-2021-248242] [PMID]
19. Luketina RR, Knauer M, Köhler G, et al. Comparison of a standard CO2 pressure pneumoperitoneum insufflator versus AirSealTM: Study protocol of a randomized controlled trial. Trials. 2014;15(1):1-6. [DOI:10.1186/1745-6215-15-239] [PMID] [PMCID]
20. van Dijk JEW, Dedden SJ, Geomini PMAJ, Meijer P, van Hanegem N, Bongers MY. Post lAparoscopic reduction of pain by combining intraperitoneal normal saline and the pulmonary recruitment maneuver (POLAR BEAR trial). RCT to estimate reduction in pain after laparoscopic surgery when using a combination therapy of intraperitoneal normal saline and the pulmonary recruitment maneuver. BMC Womens Health. 2017;17(1). [DOI:10.1186/s12905-017-0397-8] [PMID] [PMCID]
21. 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. 2021;16(4 (oct 2020-dec 2020)):116-9. [DOI:10.51273/esc20.2516425]
22. Vindal A, Sarda H, Lal P. Laparoscopically guided transversus abdominis plane block offers better pain relief after laparoscopic cholecystectomy: results of a triple blind randomized controlled trial. Surg Endosc. 2021;35(4):1713-21. [DOI:10.1007/s00464-020-07558-9] [PMID]
23. Agarwal L, Kumawat S, Jain SA, Yadav A, Sharma S. Correlation of shoulder tip pain in case of low pressure and standard pressure pneumoperitoneum post laparoscopic cholecystectomy. Int Surg J. 2021;8(5):1522. [DOI:10.18203/2349-2902.isj20211820]
24. Saito T, Iwamoto S, Murotani K, et al. Efficacy of celecoxib as preemptive analgesia for patients undergoing laparoscopic inguinal hernia repair: a randomized trial. Surg Today. 2021;51(7):1118-25. [DOI:10.1007/s00595-020-02199-w] [PMID]
25. Cunniffe MG, McAnena OJ, Dar MA, Calleary J, Flynn N. A prospective randomized trial of intraoperative bupivacaine irrigation for management of shoulder-tip pain following laparoscopy. Am J Surg. 1998;176(3):258-61. [DOI:10.1016/S0002-9610(98)00150-0] [PMID]
26. Johnson N, Onwude JL, Player J, et al. Pain after laparoscopy: An observational study and a randomized trial of local anesthetic. J Gynecol Surg. 1994;10(3):129-38. [DOI:10.1089/gyn.1994.10.129] [PMID]
27. Litynski GS. Kurt Semm and an Automatic Insufflator. JSLS J Soc Laparoendosc Surg. 1998;2(2):197-200.
28. Eryilmaz HB, Memiş D, Sezer A, Inal MT. The effects of different insufflation pressures on liver functions assessed with limon on patients undergoing laparoscopic cholecystectomy. Sci World J;2012. [DOI:10.1100/2012/172575] [PMID] [PMCID]
29. Neudecker J, Sauerland S, Neugebauer E, et al. The European Association for Endoscopic Surgery clinical practice guideline on the pneumoperitoneum for laparoscopic surgery. Surg Endosc Other Interv Tech. 2002;16(7):1121-43. [DOI:10.1007/s00464-001-9166-7] [PMID]
30. Ylinen J, Nikander R, Nykänen M, Kautiainen H, Häkkinen A. Effect of neck exercises on cervicogenic headache: A randomized controlled trial. J Rehabil Med. 2010;42(4):344-9. [DOI:10.2340/16501977-0527] [PMID]
31. Hua J, Gong J, Yao L, Zhou B, Song Z. Low-pressure versus standard-pressure pneumoperitoneum for laparoscopic cholecystectomy: A systematic review and meta-analysis. Am J Surg. 2014;208(1):143-50. [DOI:10.1016/j.amjsurg.2013.09.027] [PMID]
32. Kandil TS, Hefnawy E El. Shoulder pain following laparoscopic cholecystectomy: Factors affecting the incidence and severity. J Laparoendosc Adv Surg Tech. 2010;20(8):677-82. [DOI:10.1089/lap.2010.0112] [PMID]
33. K Rajneesh, H Ankur, G Subhash, RW Singh .A Study to Evaluate Role of Intraperitoneal Saline Wash for Shoulder Tip Pain Reduction after Laparoscopic Cholecystectomy. Surg Curr Res. 2017;07(05). [DOI:10.4172/2161-1076.1000301]
34. Bhattacharjee HK, Jalaludeen A, Bansal V, et al. Impact of standard-pressure and low-pressure pneumoperitoneum on shoulder pain following laparoscopic cholecystectomy: a randomised controlled trial. Surg Endosc. 2017;31(3):1287-95. [DOI:10.1007/s00464-016-5108-2] [PMID]
35. Gurusamy KS, Vaughan J, Davidson BR. Low pressure versus standard pressure pneumoperitoneum in laparoscopic cholecystectomy. Cochrane Database Syst Rev. 2014;2014(3):Cd006930. [DOI:10.1002/14651858.CD006930.pub3] [PMCID]
36. Chang W, Yoo T, Cho WT, Cho G. Comparing postoperative pain in various pressure pneumoperitoneum of laparoscopic cholecystectomy: A double-blind randomized controlled study. Ann Surg Treat Res. 2021;100(5):276-81. [DOI:10.4174/astr.2021.100.5.276] [PMID] [PMCID]
37. Sandhu T, Yamada S, Ariyakachon V, Chakrabandhu T, Chongruksut W, Ko-Iam W. Low-pressure pneumoperitoneum versus standard pneumoperitoneum in laparoscopic cholecystectomy, a prospective randomized clinical trial. Surg Endosc. 2009;23(5):1044-7. [DOI:10.1007/s00464-008-0119-2] [PMID]
38. Gohil A. Comparison of low pressure versus standard pressure pneumoperitoneum for elective laparoscopic cholecystectomy in a tertiary care institute of western India. Int Surg J. 2018;5(5):1776. [DOI:10.18203/2349-2902.isj20181569]

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