Effect of artificial pneumoperitoneal lavage on shoulder pain after laparoscopic cholecystectomy

doi:10.3877/cma.j.issn.1674-0793.2019.03.007

Abstract

Abstract:

Objective

To investigate the effect of peritoneal lavage on shoulder pain after laparoscopic cholecystectomy (LC).

Methods

From March 2016 to June 2018, one hundred and twenty patients with LC in Xiaolan Hospital Affiliated to Southern Medical University were randomly divided into groups A, B and C, with 40 cases in each group. As the control group, Group A didn’t perform abdominal lavage; Group B underwent peritoneal lavage with warm saline (0.9% sodium chloride solution at 37.5 C); Group C underwent subphrenic warm saline lavage before CO₂ pneumoperitoneum filling, then abdominal lavage was performed again after operation. The postoperative shoulder tip pain score (VAS) and incidence of moderate to severe pain were compared among the three groups at 6, 12, 24 and 48 hours after operation.

Results

The VAS scores of shoulder pain in three groups at different time points 48 hours after operation showed significant differences (all P<0.05), and the degree of shoulder pain in group C was the lightest. The incidence of moderate to severe shoulder pain in group A, B and C were 27.5% (11/40), 7.5% (3/40) and 2.5% (1/40) respectively, the overall difference was statistically significant (χ²=12.708, P=0.002). The incidence of shoulder pain in group A was significantly higher than that in group B and C (χ²=4.242, 7.941; P=0.039, 0.005), while the incidence of shoulder pain in group B and C showed no significantly difference (χ²=0.263, P=0.608).

Conclusion

Warm saline lavage can obviously reduce the incidence of postoperative pain, reduce the intensity of shoulder tip pain after operation, and the degree of shoulder pain after warm saline lavage performed before pneumoperitoneum is the lightest.

Key words: Sodium chloride, Cholecystectomy, laparoscopic, Peritoneal lavage, Instillation, drug, Shoulder pain

Hanghang Ni, Zemin Hu, Shuqiang Liu, Wei Hua, Xuefeng Jiang, Linquan Song, Zhihong Liang. Effect of artificial pneumoperitoneal lavage on shoulder pain after laparoscopic cholecystectomy[J]. Chinese Archives of General Surgery(Electronic Edition), 2019, 13(03): 198-201.

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Figures/Tables 4

References 16

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组别	例数	年龄(岁, ±s)	性别(例)		气腹压力(mmHg, ±s)	体质量指数(kg/m²)		手术时间(min, ±s )
组别	例数	年龄(岁, ±s)	男	女	气腹压力(mmHg, ±s)	<23	≥23	手术时间(min, ±s )
A组	40	51.8±12.6	12	28	11.8±1.1	15	25	51.1±17.4
B组	40	52.4±16.7	19	21	11.6±0.9	18	22	54.5±19.1
C组	40	52.4±14.4	17	23	11.7±0.9	19	21	55.2±21.2
统计值	?	F=0.023	χ²=2.708		F=0.390	χ²=0.882		F=0.516
P值	?	0.977	0.258		0.678	0.643		0.598

组别	例数	年龄(岁, ±s)	性别(例)		气腹压力(mmHg, ±s)	体质量指数(kg/m²)		手术时间(min, ±s )
组别	例数	年龄(岁, ±s)	男	女	气腹压力(mmHg, ±s)	<23	≥23	手术时间(min, ±s )
A组	40	51.8±12.6	12	28	11.8±1.1	15	25	51.1±17.4
B组	40	52.4±16.7	19	21	11.6±0.9	18	22	54.5±19.1
C组	40	52.4±14.4	17	23	11.7±0.9	19	21	55.2±21.2
统计值	?	F=0.023	χ²=2.708		F=0.390	χ²=0.882		F=0.516
P值	?	0.977	0.258		0.678	0.643		0.598

组别	例数	6 h	12 h	24 h	48 h
A组	40	2.3±1.3	2.5±1.3	1.9±0.9	1.1±0.7
B组	40	1.6±1.0	1.8±0.9	1.3±0.6	0.9±0.2
C组	40	1.0±0.6	1.2±0.7	0.5±0.2	0.3±0.3
整体比较F,P	?	16.724, <0.001	15.877, <0.001	39.259, <0.001	29.062, <0.001
组间比较t值^a,b,c	?	2.687, 5.846, 3.216	2.661, 5.388, 3.280	3.151, 8.736, 6.770	2.312, 6.550, 7.913
组间比较P值^a,b,c	?	0.009, <0.001, 0.002	0.009, <0.001, 0.002	0.002, <0.001, <0.001	0.023, <0.001, <0.001

组别	例数	6 h	12 h	24 h	48 h
A组	40	2.3±1.3	2.5±1.3	1.9±0.9	1.1±0.7
B组	40	1.6±1.0	1.8±0.9	1.3±0.6	0.9±0.2
C组	40	1.0±0.6	1.2±0.7	0.5±0.2	0.3±0.3
整体比较F,P	?	16.724, <0.001	15.877, <0.001	39.259, <0.001	29.062, <0.001
组间比较t值^a,b,c	?	2.687, 5.846, 3.216	2.661, 5.388, 3.280	3.151, 8.736, 6.770	2.312, 6.550, 7.913
组间比较P值^a,b,c	?	0.009, <0.001, 0.002	0.009, <0.001, 0.002	0.002, <0.001, <0.001	0.023, <0.001, <0.001

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