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Research and Opinion in Anesthesia & Intensive Care
Wolters Kluwer - Medknow
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| Abstract: |
Purpose
The aim was to evaluate the effect of combination of recruitment maneuver (RM) or
intraperitoneal saline infusion (IPS) to low-pressure pneumoperitoneum in reducing
postlaparoscopic shoulder and abdominal pain in patients undergoing laparoscopic
gynecologic surgeries.
Patients and methods
This prospective blinded randomized controlled study was conducted on
108 patients undergoing laparoscopic gynecologic surgery. Patients were
randomly allocated to four groups: group C (control group) patients received
standard pressure pneumoperitoneum, group L received low-pressure
pneumoperitoneum, group LR received low-pressure pneumoperitoneum and
intermittent five times RM at a pressure of 40 cmH2O, and group LS received
low-pressure pneumoperitoneum and IPS (15–20 ml/kg). Primary outcome was
visual analog scale score for shoulder pain and abdominal pain at 2, 6, 12, 24, 48,
72, and 96 h postoperatively.
Results
The visual analog scale values of shoulder pain and abdominal pain were
statistically significantly higher in the control group at different timings
postoperatively compared with the interventional groups. Moreover, the LR
group had the lowest statistically significant values at all different timings except
at 2, 48, 72, and 96 h, where it had no significant difference with the LS group
regarding shoulder pain. However, regarding abdominal pain values, the LS group
had the lowest statistically significant values at 72 and 96 h postoperatively.
Conclusion
Adding of RM or IPS to low-pressure insufflation could significantly decrease the
intensity of postlaparoscopic shoulder and abdominal pain. However, RM seems to
be more effective but it is a relatively short-acting maneuver, whereas IPS seems to
be less effective but it has a longer lasting effect.
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