EFFECT OF LOW-PRESSURE PNEUMOPERITONEUM VERSUS STANDARD PRESSURE PNEUMOPERITONEUM IN LAPAROSCOPIC CHOLECYSTECTOMY ON POST-OPERATIVE PAIN

Abstract

Objective:To compare postoperative pain scores after laparoscopic cholecystectomy under low pressure versus standard pressure pneumoperitoneum.

Study Design:   Quasi-Experimental Trial

Place and duration: Surgery Department Tertiary care Hospital, Kharian February 2024-July 2024.

Methods: Patients from either gender, aged 18-50 years, who had ASA grade I or II and were diagnosed with symptomatic cholelithiasis were included. After employing a non-probability consecutive sampling technique, 102 patients were recruited. Group A included 51 patients subject to low pressure pneumoperitoneum while 51 patients from Group B were subject to standard pressure pneumoperitoneum. The primary outcome was a pain score on the visual analogue scale while secondary outcomes included post-operative complications and duration of hospital stay.

Results: Gender distribution revealed a female predominance with a frequency of 80 (78.43%) as compared to 22(21.57%) males. Median age and BMI  between the two groups were comparable. Pain assessment on a VAS at 02 hours, 06 hours, and 12 hours revealed significantly lesser pain scores in Group A as compared to Group B. Frequency of postoperative complications in Group A was 5 (9.8%) as compared to 17 (33.3%) in Group B (p-0.004). Rescue analgesia was administered more frequently in Group B as compared to Group A. Median length of Hospital stay in Group A was 38 (36-39) as compared to 41 (40-42) in Group B (p-0.000).

Conclusion:     Laparoscopic cholecystectomy under low-pressure pneumoperitoneum offers superior analgesia post-operatively with significantly lesser complications post-operatively, decreased requirement of rescue analgesia and significantly reduced the length of hospital stay.