Reviewer ’s report  
 
Title:  RCT to estimate reduction in pain after laparoscopic surgery when using a combination 
therapy of intraperitoneal normal saline and the pulmonary recruitment maneuver.  
 
Version: 1 Date: 09 Jun 2016 
 
Reviewer:  Ross  Hansen  
 
Reviewer’ s report:  
 
This is an interesting protocol; the proposed trial has potential to improve the surgical 
management of a large population of women. Please note the following suggestions:  
 
1. Page 5, line 87 sentence would read better as "A combination of the t echniques described 
above has been shown to reduce.... pain"...  
 
2. Considering the potential impact of BMI, should randomisation also be stratified by two or 
three BMI categories?  
 
3. Page 8, line 153, control group: is there any time limit involved in th e application of 
abdominal pressure (to standardise this)?  
 
4. Page 8, line 169. More information re these "inputs" would be helpful. Is 48 hours the 
timepoint expected to show the maximum pain difference between groups?  
 
5. Statistics, pages 8,9: I expect ed pain incidence to be evaluated by a distribution -based test 
such as chi -squared or similar, and pain intensity to be evaluated by a two -way repeat measures 
ANOVA (or similar general linear model).  
 
Are the methods appropriate and well described?  
If not,  please specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?   
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported b y the data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please spec ify what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Acceptable  
 
Declaration of competing interests  
Please c omplete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publication of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying  for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other financial c ompeting interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give details below.  
 
I declare that I have no competing interests.  
 
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