J Korean Surg Soc.  2006 Apr;70(4):307-311.

Postoperative Pain Differences between Different Insufflation Pressures on Laparoscopic Cholecystectomy

• O JT
• Park DE
• Chae KM

Abstract

PURPOSE: There were many studies for adverse effects of carbon dioxide insufflation for laparoscopic cholecystectectomy, mainly focused on cardiovascular and respiratory system. The use of low pressure pneumoperitoneum has been shown to reduce adverse hemodynamic effects. However, its effect on tissue trauma & postoperative pain remains controversial. The aim of this study was to compare postoperative pain intensity between different insufflation pressures in laparoscopic cholecystecetomy.
METHODS
We randomly allocated fifty four patients to 7 mmHg (LC7), 9 mmHg (LC9) and 12 mmHg (LC12) pneumoperitoneum group and examined operation time, postoperative pain intensity using visual analogue scale, amount of administered analgesics and complications prospectively.
RESULTS
The characteristics of the patients were similar among groups. The procedure was successfully completed in all patients in the LC12 gruop, but in five patients of LC7 group and one patient of LC9 group the insufflation pressure was increased to 12 mmHg to complete the operation. There were no significant difference in postoperative pain scores, analgesic comsumptions among groups. There were difficulties to get a safe hemostasis and to create a adequate working space at acute cholecystitis in LC7 group.
CONCLUSION
In our study, there was no superior advantage for postoperative pain when low pressure pneumoperitoneum was applied.

Keyword

Laparoscopic cholecystectomy; Pneumoperitoneum; Low-pressure pneumoperitoneum

MeSH Terms

Analgesics
Carbon Dioxide
Cholecystectomy, Laparoscopic*
Cholecystitis, Acute
Hemodynamics
Hemostasis
Humans
Insufflation*
Pain, Postoperative*
Pneumoperitoneum
Prospective Studies
Respiratory System
Analgesics
Carbon Dioxide