Pulmonary Recruitment Maneuver for Postlaparoscopic Shoulder Pain

Study Overview
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Brief Summary
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The aim of this clinical trial is to evaluate the efficacy and safety of different recruitment maneuvers for reducing postlaparoscopic shoulder pain.

Detailed Description
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Shoulder pain after laparoscopy is common and its probable mechanism is residual CO2 gas after surgery. The pulmonary recruitment maneuver can mechanically remove residual CO2 and reduce pain. In literature, there are two different recruitment maneuvers, which was manual inflation of the lungs with positive pressure ventilation of either 40cmH2O or 60cmH2O at the end of surgery. However, the higher positive pressure may be associated with more chance of barotrauma. Therefore, it is important to determine the lowest effective pressure for reducing postlaparoscopic shoulder pain. The aim of this clinical trial is to evaluate the efficacy and safety of different recruitment maneuvers (40cmH2O or 60cmH2O) for reducing postlaparoscopic shoulder pain.

Official Title
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Pulmonary Recruitment Maneuver to Reduce Postlaparoscopic Shoulder Pain: Randomized Controlled Trial

Conditions
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Gynecologic Diseases

Intervention / Treatment
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* Procedure: 40 cmH2O
* Procedure: 60 cmH2O
* Procedure: Passive deflation


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: patients undergoing laparoscopy for benign gynecologic diseases patients aged 19-65 years patients with american society of anesthesiology physical status I-II patients obtaining written informed consent Exclusion Criteria: patients with chronic shoulder pain, chronic epigastric pain or chronic pain syndrome patients with past history of pneumothorax or any pulmonary surgical history patients with any shoulder surgery histories patients who required to conversion to open surgery from laparoscopic surgery patients who required to receive incidental upper abdominal surgeries due to adhesion and injury at upper abdominal cavity patients with inability to understand or express 10 point visual analogue scale intrauterine pregnant women

Ages Eligible for Study
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Minimum Age: 19 Years
Maximum Age: 65 Years

Sexes Eligible for Study
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Female

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Prevention
Allocation: Randomized
Intervention Model: Parallel Assignment
Masking: Triple


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Passive deflation<br>In the controls, CO2 was removed by the traditional passive deflation of abdominal cavity. | Procedure: Passive deflation<br>* In the controls, CO2 was removed by the traditional passive deflation of abdominal cavity.<br>|
| Experimental: 40 cmH2O<br>The intervention was five manual inflations of the lungs with positive pressure ventilation of 40 cmH2O at the end of surgery. | Procedure: 40 cmH2O<br>* The intervention was five manual inflations of the lungs with positive pressure ventilation of 40 cmH2O at the end of surgery.<br>|
| Experimental: 60 cmH2O<br>The intervention was five manual inflations of the lungs with positive pressure ventilation of 60 cmH2O at the end of surgery. | Procedure: 60 cmH2O<br>* The intervention was five manual inflations of the lungs with positive pressure ventilation of 60 cmH2O at the end of surgery.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Shoulder pain | The pain score was evaluated by 10 point visual analogue scale. | after two day of procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Wound pain | The pain score was evaluated by 10 point visual analogue scale. | after two day of procedure |