Correlation of Intra-Abdominal Co2 Pressure in Laparoscopic Cholecystectomy to Shoulder-Tip Pain
BACKGROUND KNOWLEDGE: Most of the time patients complain of pain at the tip of shoulder after undergoing Lap. Cholecystectomy. This study was conducted to find relation of low pressure pneumoperitoneum generated during lap. Cholecystectomy and reduced incidence of shoulder tip pain after operation.
Material and Methods: This is a prospective type study. It was done on 100 patients reported in surgical unit of Bahawal Victoria Hospital Bahawalpur from 1st February 2017 to 31st January 2018. They were divided into two groups. In group-A (60) those patients were kept in which low pressure pneumoperitoneum was generated with 12mmHg CO2 pressure and in group-B (40) those patients were included in which normal pressure pneumoperitoneum was generated with 16 mmHg CO2 pressure for laparoscopic cholecystectomy. Finding was recorded on pain scale 1, 4, 8, 12, 16, 24 and 48 hours of operation.
Results: In low pressure peritoneum normal surgery was done without increase of duration and no complication was noticed. After operation 20() patients from group A and 9 patients from group B complained of shoulder tip pain. Its mean duration was 16 hours after operation. Pain was settled after using mild analgesia in both groups. No other complication occurred. High dose of analgesia was not required.
Conclusion: It is concluded that low pressure of CO2 used to generate pneumoperitoneum lowers the chances of shoulder tip pain after laparoscopic cholecystectomy and lowers the severity of pain as well.
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