Ann Surg Treat Res.  2017 Oct;93(4):181-185. 10.4174/astr.2017.93.4.181.

Effect of intraperitoneal COâ‚‚ concentration on postoperative pain after laparoscopic cholecystectomy

• Chung JW
• Kang KS
• Park SH
• Kim CS
• Chung JH
• Yoo SH
• Kim NS
• Seo YH
• Jung HS
• Chun HR
• Gong HY
• Jung HI
• Bae SH
• Park SY

• KMID: 2392367
• DOI: http://doi.org/10.4174/astr.2017.93.4.181

Abstract

PURPOSE
This study set out to identify the association between the intraperitoneal COâ‚‚ concentrations and postoperative pain by dividing the participants into a control group and 2 experimental groups receiving irrigation (1 L and 2 L), and directly measuring their intraperitoneal COâ‚‚ concentrations with a COâ‚‚ gas detector.
METHODS
A total of 101 patients, American Society of Anesthesiologists physical status classification I and II patients aged 18-65 years were enrolled in the study. Group 1 did not receive irrigation with normal saline, while groups 2 and 3 were administered irrigation with 1 L and 2 L of normal saline, respectively, after laparoscopic cholecystectomy. Intraperitoneal COâ‚‚ concentrations were measured with a COâ‚‚ gas detector through the port, and postoperative pain was assessed on a visual analogue scale at 6, 12, and 24 hours after surgery.
RESULTS
The intraperitoneal COâ‚‚ concentrations were 1,016.0 ± 960.3 ppm in group 1, 524.5 ± 383.2 ppm in group 2, and 362.2 ± 293.6 ppm in group 3, showing significantly lower concentrations in groups 2 and 3. Postoperative pain was significantly lower in group 3 at 6 hours after surgery, and in groups 2 and 3 at 12 hours after the surgery. However, there was no significant difference between the 3 groups in postoperative pain 24 hours after the surgery.
CONCLUSION
This study found a causal relationship between the amount of normal saline used for irrigation and the intraperitoneal COâ‚‚ concentrations in that irrigation with normal saline reduces pain on the day of the surgery.

Keyword

Intraperitoneal carbon dioxide; Saline waters; Postoperative period pain; Carbon dioxide gas detector

MeSH Terms

Cholecystectomy, Laparoscopic*
Classification
Humans
Pain, Postoperative*
Saline Waters

Figure

• 

  Fig. 1 VAS for postoperative pain at 6, 12, and 24 hours after laparoscpic cholecystectomy. And difference of intra-abdominal CO2 concentration among 3 groups. G1, no irrigation group; G2, 1-L irrigation group; G3, 2-L irrigation group.

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