Intraperitoneal Lavage for Reducing Pain in Laparoscopy
Condition: Pain, Postoperative
MeSH terms: Pain, Postoperative
Study type: Interventional

Summary: 
      The aim of the present study is to evaluate the role of intraperitoneal washing irrigation
      with saline solution at the end of laparoscopic hysterectomy or myomectomy in reducing
      perception of postoperative pain.
    

Detailed description: 
      Patients will be fully and accurately informed on the type of intervention and will sign a
      specific informed consent, in accordance with CBM standards, both for the intervention to
      which the patient will undergo both for the study in question.

      Randomization will be performed through a randomized randomization table generated by a
      computer. Patients will therefore be divided into two groups:

      A - Yes Washing (SL) B - No Washing (NL) Prior to surgery, hemoglobin and PCR values will be
      evaluated in the preoperative.

      Prior to the incision, an antibiotic prophylaxis will be performed with cefazoline 2gr
      intravenously.

      The intervention in both groups involves the periombelic cutaneous incision and the
      sub-umbilical band. Introduction of 10mm led trocar based on open technique. The introduction
      of optics and CO2 insufflation allows the macroscopic visualization of the endotominal
      organs. The investigators proceed with the introduction of 3 additional 3-lane trocar
      accessories in the left iliac fossa, right and overlaid iliac thorax. You will perform a
      hysterectomy possibly associated with annessiectomy or myomectomy according to the surgical
      indication. Careful hemostasis is carried out. In the SL group, the washing process is
      continued. In particular, 1000cc of laced ringer is instilled by changing the position of the
      patient in Trendelenburg and Anti-Trendelenburg so that the liquid contacts not only the
      internal surgical wounds but the whole wall of the abdominal cavity. The surgery ends with
      the closure of the band and the breasts cutaneous. The parameters measured during the
      operation are: operating time, amount of CO2 injected (L), pneumoperitoneal pressure (mmHg).
      The operator surgeon is always the same.

      In the postoperative period, the following parameters will be evaluated: hemoglobin, white
      blood cells, PCR, body temperature, recovery of intestinal activity, administration of
      toradol, paracetamol and possible morphine and postoperative postoperative pain, palpation,
      cough. The latter is evaluated through tables using the VAS visual scale: patients report the
      subjective characteristics of perceived postoperative pain by attributing a value of 0 (no
      pain) to 10 (worse pain than I can imagine). It assesses the occurrence of any complications
      in post-operative, infection and fever, which may require the patient's exclusion from the
      study.
    

Intervention name(s): intraperitoneal washing with saline solution; No washing
Intervention type(s): Procedure; Procedure
Intervention description(s): intraperitoneal washing at the end of surgery; no washing
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: Patients will therefore be divided into two groups:
A - Yes Washing (SL) B - No Washing (NL)
Masking: Double (Participant, Investigator)
Primary purpose: Treatment
Keywords: pain; laparoscopy; washing; intraperitoneal irrigation