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[Postoperative pain in patients undergoing elective laparoscopic cholecystectomy with low versus standard-pressure
C H Sandoval-Jiménez1, G J Méndez-Sashida, L M Cruz-Márquez-Rico
1Servicio de Cirugía General, Hospital de Especialidades No. 1, León, Guanajuato, IMSS. mdsandoval@hotmail.com
Background:
Laparoscopic cholecystectomy is the gold standard in the management of symptomatic gallstone disease. Postoperative abdominal and shoulder-tip pain are the main adverse side effects.
Aim:
To determine whether the low-pressure pneumoperitoneum (7 mmHg) decreases postoperative pain in patients undergoing laparoscopic cholecystectomy compared with standard pressure pneumoperitoneum (12-15 mmHg).
Material And Methods:
Double-blind clinical trial that included 68 patients divided into two groups: low-pressure and standard pressure pneumoperitoneum. Main variables assessed were abdominal pain at 6, 12 and 24 hours (by visual analogue scale), the incidence of shoulder- tip pain, time and quality of exposure of the surgical field. Variables were compared using Chi square and T-Student, considering significance at p<0.05.
Results:
The demographic characteristics of patients were similar in both groups. Abdominal pain was significantly less at 12 and 24 hours in the group with low-pressure pneumoperitoneum (p=0.02). The presence of shoulder-tip pain occurred more frequently in the group with standard- pressure pneumoperitoneum (p=0.007).
Conclusions:
Low-pressure pneumoperitoneum significantly reduces abdominal and shoulder tip pain. Key words: pneumoperitoneum, laparoscopic cholecystectomy, postoperative pain, shoulder pain, complications, Mexico.
