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: 13 Jun 2016 
 
Reviewer:  Lashen  Hany  
 
Reviewer’ s report:  
 
this is an interesting study and I look forward to reading the results of it.  However, as the results 
section is absent I believe this is an attempt to publish the protocol prior to starting or completing 
the study.  My comments therefore will be regarding the methodology.  
 
There are some Grammatical errors however given that the authors are not native English 
speakers I think they have done well.  They need also to spell fully all the acronyms as they first 
use them.  They need to mention how t he randomization will take place with special reference to 
the stratification process as to what factors they controlled for by stratified randomization.  They 
are using a combination of instillation of normal saline and pulmonary recruitment maneuver 
howe ver in their analysis they have not specified how they will differentiate which of the two 
had the major effect on reducing postoperative shoulder tip pain, if it at all does.  I believe that 
will be difficult unless they introduce two more groups that has  either instillation of saline or 
pulmonary recruitment maneuver alone so that they can establish if the combination or any of the 
two procedures was more effective in reducing pain..  
 
Are the methods appropriate and well described?  
If not, please specify what is required in your comments to the authors.  
 
Yes 
 
Does the work include the necessary controls?   
If not, please specify which controls are required in your comments to the authors.  
 
No 
 
Are the conclusions drawn adequately supported by the data shown ? 
If not, please explain in your comments to the authors.  
 
No 
 
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 specify 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:  
 
Needs some language corrections before being published  
 
Declaration of c ompeting interests  
Please complete 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 financial ly from the publication of this 
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3. Do you hold or  are you currently applying for any patents relating to the content of the 
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4. Have you received reimbursements, fees, funding, or salary from an organization that 
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5. Do you  have any other financial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
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below. If your reply is yes to any,  please give details below.  
 
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