title: Effects of Intra-abdominally Instilled Isotonic Saline on Pain, Recovery, and Health-Related Quality-of-Life Following Laparoscopic Cholecystectomy: A Randomized Prospective Double-Blind Controlled Study.
abstract: BACKGROUND
  The postoperative installation of isotonic saline in the abdomen has been suggested as a method to reduce the effect of local toxins, thereby reducing postoperative pain in patients undergoing laparoscopic surgery. The aim of this randomized prospective double-blind trial was to assess whether installation of isotonic saline can reduce postoperative pain and nausea following laparoscopic cholecystectomy (LC).
  
  
  METHODS
  Altogether 71 LC patients were randomized to either intra-abdominal instillation of isotonic saline group (S) (n = 36) or no saline (NS) group (n = 35) at the end of surgery. Data were collected by means of questionnaires. The postoperative recovery profile questionnaire was answered prior to surgery and 1 week postoperatively, SF-36 prior to surgery and at 1 month postoperatively, and a pain diary recording a Visual Analogue Scale score each day during the first week.
  
  
  RESULTS
  The overall response rate was 94%. No significant differences were seen between the groups regarding abdominal and shoulder pain. However, the NS group reported more pain (NS = 53 %, S = 29 %) and fatigue (NS = 50%, S = 35%) than the S group postoperative day 7. Moreover, the most frequently reported problem in both groups 7 days after surgery was getting back to normal life (60%). Females reported a slower recovery profile than males and also more postoperative symptoms day 7. HRQoL results were similar between the groups.
  
  
  CONCLUSIONS
  Instillation of isotonic saline does not improve recovery after laparoscopic cholecystectomy. Postoperative pain was more often reported in the NS group than in the S group, though the difference was not significant.
authors: Department of Anesthesia and Intensive Care, B42, Karolinska University Hospital Huddinge, 141 86, Stockholm, Sweden, cajsa.barthelsson@ki.se.
authors: C
authors: C
authors: Barthelsson
authors: G
authors: G
authors: Sandblom
authors: S
authors: S
authors: Ljesevic-Nikoletic
authors: F
authors: F
authors: Hammarqvist
mesh_terms: D000005:Abdomen; D015746:Abdominal Pain / Q000209:etiology / Q000517:prevention & control; D000328:Adult; D000368:Aged; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007322:Instillation, Drug; D007552:Isotonic Solutions / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000209:etiology / Q000517:prevention & control; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011446:Prospective Studies; D011788:Quality of Life; D012737:Sex Factors; D020069:Shoulder Pain / Q000209:etiology / Q000517:prevention & control; D012965:Sodium Chloride / Q000008:administration & dosage*; D013997:Time Factors
chemical_list: D007552:Isotonic Solutions; D012965:Sodium Chloride