Abstract :
Introduction: C02 pneumoperitoneum in laparoscopic cholecystectomy leads to shoulder -tip pain in the post operative period. There are many methods to reduce it like analgesic drugs , intraperitoneal saline, lowpressure gas,and intraperitoneal local anaesthetic. The aim of our study is to evaluate the combination of intraperitoneal infusion of saline and low pressure (lOmmg) C02 pneumoperitoneum in decreasing the shoulder tip pain postoperatively. Methods: The study was in Fayoum University Hospital in the period from May 2010 to June 2011 on 60 patients underwent elective laparoscopic cholecystectomy. They were classified into 2 groups Group A (n=35) underwent laparoscopic cholecystectomy using 14mm Hg C02 pneuomoperitoneum,Group B (n=25)underwent laparoscopic cholecystectomy using lOmmHg C02 pneumoperitoneum and infusion of normal saline in the right subdiaphragmatic region. Recording shoulder tip pain by visual analogue scale (VAS) post operatively at 2,8,12,24, and48 hours, (fig. 1). Results: Fourteen patients (40%) in GroupA complained of shoulder tip pain, 3 patient (12%)in GroupB complained of shoulder tip pain ,therewas a significant difference between 2 groups after 2 hours post operatively P 0.0001, the post operative scores for shoulder tip pain were reduced at 8,12, and 24 hours. The number of patients in Group B needed analgesics was less than in Group A. Conclusions: Intra peritoneal infusion of normal saline and low pressure (lOmmHg) C02 reduced the frequency of post operative shoulder-tip pain post laparoscopic cholecystectomy.
