[Postoperative pain in patients undergoing elective laparoscopic cholecystectomy with low versus standard-pressure pneumoperitoneum. A randomized clinical trial.].
BACKGROUND
Laparoscopic cholecystectomy is the gold standard in the management of symptomatic gallstone disease. Postoperative abdominal and shoulder-tip pain are the main adverse side effects.


OBJECTIVE
To determine whether the low-pressure pneumoperitoneum (7 mmHg) decreases postoperative pain in patients undergoing laparoscopic cholecystectomy compared with standard pressure pneumoperitoneum (12-15 mmHg).


METHODS
Double-blind clinical trial that included 68 patients divided into two groups: low-pressure and standard pressure pneumoperitoneum. Main variables assessed were abdominal pain at 6, 12 and 24 hours (by visual analogue scale), the incidence of shoulder- tip pain, time and quality of exposure of the surgical field. Variables were compared using Chi square and T-Student, considering significance at p<0.05.


RESULTS
The demographic characteristics of patients were similar in both groups. Abdominal pain was significantly less at 12 and 24 hours in the group with low-pressure pneumoperitoneum (p=0.02). The presence of shoulder-tip pain occurred more frequently in the group with standard- pressure pneumoperitoneum (p=0.007).


CONCLUSIONS
Low-pressure pneumoperitoneum significantly reduces abdominal and shoulder tip pain. Key words: pneumoperitoneum, laparoscopic cholecystectomy, postoperative pain, shoulder pain, complications, Mexico.
Sandoval-Jiménez
C H
CH
Servicio de Cirugía General, Hospital de Especialidades No. 1, León, Guanajuato, IMSS. mdsandoval@hotmail.com
Méndez-Sashida
G J
GJ
Cruz-Márquez-Rico
L M
LM
Cárdenas-Victorica
R
R
Guzmán-Esquivel
H
H
Luna-Silva
M
M
Díaz-Valero
R
R
D000328:Adult; D017081:Cholecystectomy, Laparoscopic; D004311:Double-Blind Method; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D010149:Postoperative Pain / Q000517:prevention & control*; D011028:Pneumoperitoneum, Artificial / Q000379:methods*; D011312:Pressure