A Randomized Controlled Trial Evaluating Post-Operative Shoulder Tip Pain in Low-Pressure [10 mmHg CO2] versus Standard Pressure [14 mmHg CO2] Pneumoperitoneum during Laparoscopic Cholecystectomy under Spinal Anesthesia: A One-Year Hospital-Based Study (Code-T0226)
Keywords:
Shoulder tip pain, pneumoperitoneum, low-pressure, standard-pressure, laparoscopic cholecystectomy, spinal anesthesia.Synopsis
Introduction: Post-operative shoulder tip pain (STP) is a common complaint following laparoscopic cholecystectomy (LC), often attributed to carbon dioxide (CO2) insufflation during pneumoperitoneum. The impact of CO2 insufflation pressure on STP remains inconclusive. This study compares post-operative STP between low-pressure (10 mmHg CO2) and standard pressure (14 mmHg CO2) pneumoperitoneum in patients undergoing LC 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
- To evaluate post op shoulder tip pain in patients subjected randomly to low and normal pressure pneuperitoneum
- To evaluate post op shoulder tip pain with reference to spinal anaesthesia [bupivacaine] plus sedation with pentazocine under random pressure pneuperitoneum
Methods: A one-year randomized controlled trial was conducted with 200 patients undergoing LC under spinal anesthesia. Participants were randomly assigned to either the low-pressure group (10 mmHg CO2) or the standard-pressure group (14 mmHg CO2). Post-operative STP intensity was assessed using the Visual Analog Scale (VAS) at 6, 12, and 24 hours post-surgery. Data were analyzed for statistical significance using appropriate tests.
Results: The low-pressure group showed a statistically significant reduction in the intensity of shoulder tip pain compared to the standard-pressure group at all time intervals (p < 0.05). The incidence of STP was also lower in the low-pressure group.
Conclusion: Low-pressure pneumoperitoneum significantly reduces the incidence and intensity of post-operative shoulder tip pain compared to standard pressure in laparoscopic cholecystectomy under spinal anesthesia. This technique could improve post-operative recovery and patient comfort.
Keywords: Shoulder tip pain, pneumoperitoneum, low-pressure, standard-pressure, laparoscopic cholecystectomy, spinal anesthesia.
