This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .
The effect of CO2 insufflation rate on the postlaparoscopic shoulder pain.
Shoulder pain ( SP ) is frequently mentioned in recent literature following laparoscopic operations . In the literature , many causes have been declared to explain shoulder pain after CO2 insufflation , such as direct peritoneal irritation of the CO2 gas , excessive traction of the triangular ligament , and overstretching of the diaphragmatic muscle fibers due to the high rate of insufflation . This study was planned as multicentric , and 76 patients , aged between 35 to 45 , were entered into the study . They were all selected by a r and omized sampling method , with equal numbers of men and women , to achieve true evaluation . The low flow-rate ( LFR ) group was insufflated with 2.5 L/min and the high flow-rate ( HFR ) group with 7.5 L/min . All cases were evaluated by subjective pain classification on postoperative day 3 . According to the subjective pain scale method , shoulder pain average was 23.9+/-3.1 in the LFR group and 55.4+/-6.5 in the HFR group . The difference between these groups was significant ( p > 0.01 ) . There is no significant difference for the operation time ( LFR% : 64+/-15 minutes , HFR : 61+/-20 minutes , p > 0.05 ) . Our results suggest that there is a significant statistical relation between the postoperative shoulder pain levels and increased insufflation rates . For this reason , low insufflation rate significantly reduces the shoulder pain but does not increase the operation time . Therefore , a low insufflation rate should be applied in all cases for patients ' comfort and safety
This approach has been design ed to provide adequate analgesia while minimizing exposure to adverse events
Background : Laparoscopic cholecystectomy has advantages over the open procedure for postoperative pain .
However , a systematic review of postoperative pain management in this procedure has not been conducted .