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Title: Effects of Low and Standard Intra-Abdominal Pressure on Postoperative Pain in Laparoscopic Cholecystectomy
Authors: Afaque Ali, Zaki Hussain, Ayesha Jamal, Fatima Rahat, Talha Makshoof, Saqib Islam
Journal: Pakistan Armed Forces Medical Journal (PAFMJ)
Publisher: Army Medical College, Rawalpindi.
Country: Pakistan
Year: 2022
Volume: 72
Issue: 3
Language: English
DOI: 10.51253/pafmj.v72i3.4163
Keywords: Post-operative painLaparoscopic cholecystectomyLaparoscopiccholecystectomiesPost-cholecystectomy syndromePneumatic Pressure
Objective: To analyze the effects of low and standard intra-abdominal pressure on post-operative pain in laparoscopic cholecystectomy.
Study Design: Comparative prospective study.
Place and Duration of the Study: Department of General Surgery, Pak Emirates Military Hospital Rawalpindi, from Nov 2019 to Feb 2020.
Methodology: The study comprised 53 patients who underwent Laparoscopic Cholecystectomy and were selected for the study. They were randomly divided into two groups by third-party randomization. The first group was operated on under low pneumatic pressure, i.e. 8-12 mmHg and the second group was operated on under high pneumatic pressure, i.e. (≥15 mmHg). The complaint of post-operative pain was evaluated using a visual analogue scale (VAS) in the next 12 hours.
Results: The group that was operated under high pneumatic pressure showed a higher occurrence of post-operative pain (50.9%) than the group that operated under low pneumatic pressure. On the Visual Analogue Scale, 80.0% of patients with high pneumatic pressure showed a pain of score four or more which is very high compared to the other group (p <0.05).
Conclusion: The patients operated for laparoscopic cholecystectomy under low-pressure pneumoperitoneum would suffer from less post-operative abdominal pain, which needs less analgesia and leads to early hospital discharge.
To analyze the effects of low and standard intra-abdominal pressure on post-operative pain in laparoscopic cholecystectomy.
A comparative prospective study involving 53 patients who underwent Laparoscopic Cholecystectomy. Patients were randomly divided into two groups: one operated under low pneumatic pressure (8-12 mmHg) and the other under high pneumatic pressure (15 mmHg). Post-operative pain was evaluated using a visual analogue scale (VAS) within the next 12 hours. Data was analyzed using SPSS version 26.0, with Mann-Whitney U test used for pain comparison.
graph TD
A["Patient Selection 53 patients undergoing LC"] --> B["Randomization"];
B --> C["Group 1: Low Pressure 8-12 mmHg"];
B --> D["Group 2: High Pressure 15 mmHg"];
C --> E["Laparoscopic Cholecystectomy"];
D --> E;
E --> F["Post-operative Pain Assessment VAS"];
F --> G["Data Analysis SPSS, Mann-Whitney U test"];
G --> H["Conclusion"];
The study suggests that low-pressure pneumoperitoneum in laparoscopic cholecystectomy leads to less post-operative abdominal pain, reduced need for analgesia, and potentially earlier hospital discharge. While some surgeons consider low-pressure pneumoperitoneum beneficial, its efficacy remains a topic of debate, necessitating further research. The study found a strong association between high pneumatic pressure and post-operative pain.
The group operated under high pneumatic pressure showed a higher occurrence of post-operative pain (50.9%) compared to the low pneumatic pressure group. On the Visual Analogue Scale, 80.0% of patients with high pneumatic pressure reported a pain score of four or more, which was significantly higher than the low-pressure group (p<0.05).
Patients undergoing laparoscopic cholecystectomy with low-pressure pneumoperitoneum experience less post-operative abdominal pain, require less analgesia, and may be discharged from the hospital earlier.
1. Number of patients: The study comprised 53 patients who underwent Laparoscopic Cholecystectomy. (Confirmed)
2. Low pressure range: Low pneumatic pressure was defined as 8-12 mmHg. (Confirmed)
3. High pressure value: High pneumatic pressure was defined as 15 mmHg. (Confirmed)
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