Evaluation of Postoperative Shoulder Tip Pain in Low-Pressure (10 mmHg CO₂) vs. Standard-Pressure (14 mmHg CO₂) Pneumoperitoneum During Laparoscopic Cholecystectomy Under Spinal Anesthesia: A One-Year Randomized Controlled Hospital-Based Study (Code-T0211)

Introduction: Shoulder tip pain is a common postoperative complication following laparoscopic cholecystectomy, often caused by the insufflation of CO₂ during the procedure. The standard pressure used for pneumoperitoneum is 14 mmHg, but recent studies suggest that lower pressures may reduce postoperative discomfort. This study evaluates the effect of low-pressure (10 mmHg) versus standard-pressure (14 mmHg) pneumoperitoneum on postoperative shoulder tip pain in patients undergoing laparoscopic cholecystectomy under spinal anesthesia.

Aims and Objectives:

Aim:

To Evaluate Post Operative Shoulder Tip Pain In Low Pressure [10mmhg Co2] V/S Standard Pressure [14 Mmhg Co2] Pneumoperitoneum In Lap Cholecystectomy Under Spinal Anaesthesia , A One Year Randomized Controlled Trial: Hospital Based Study

Objectives:

1. To Evaluate Post Op Shoulder Tip Pain In Patients Subjected Randomly To Low And Normal Pressure Pneuperitoneum
2. To Evaluate Post Op Shoulder Tip Pain With Reference To Spinal Anaesthesia [Bupivacaine] Plus Sedation With Pentazocine Under Random Pressure Pneuperitoneum

Methods: A randomized controlled trial was conducted over one year at a hospital. 100 patients undergoing laparoscopic cholecystectomy under spinal anesthesia were randomly assigned to two groups: one group received low-pressure (10 mmHg) pneumoperitoneum, and the other received standard-pressure (14 mmHg) pneumoperitoneum. Postoperative shoulder tip pain was assessed using a visual analog scale (VAS) at 2, 6, and 24 hours postoperatively.

Results: Patients in the low-pressure group reported significantly less shoulder tip pain at all time intervals compared to the standard-pressure group (p < 0.05). The incidence of severe pain was notably lower in the low-pressure group.

Conclusion: Low-pressure pneumoperitoneum significantly reduces postoperative shoulder tip pain compared to standard-pressure pneumoperitoneum during laparoscopic cholecystectomy under spinal anesthesia. This finding supports the use of low-pressure pneumoperitoneum as a more comfortable approach in laparoscopic surgery.

Keywords: Shoulder tip pain, Pneumoperitoneum, Laparoscopic cholecystectomy, Low-pressure, Standard-pressure, Spinal anesthesia.