title: Which intraperitoneal insufflation pressure should be used for less postoperative pain in transperitoneal laparoscopic urologic surgeries?
abstract: OBJECTIVE
  To determine whether using different intraperitoneal insufflation pressures for transperitoneal laparoscopic urologic surgeries decreases postoperative pain.
  
  
  METHODS
  76 patients who underwent transperitoneal laparoscopic upper urinary tract surgery at different insufflation pressures were allocated into the following groups: 10mmHg (group I, n=24), 12mmHg (group II, n=25) and 14mmHg (group III, n=27). These patients were compared according to age, gender, body mass index (BMI), type and duration of surgery, intraoperative bleeding volume, postoperative pain score and length of hospital stay. A visual analog scale (VAS) was used for postoperative pain.
  
  
  RESULTS
  Demographic characteristics, mean age, gender, BMI and type of surgeries were statistically similar among the groups. The mean operation time was higher in group I than group II and group III but this was not statistically significant (P=0.810). The mean intraoperative bleeding volume was significantly higher in group I compared with group II and group III (P=0.030 and P=0.006). The mean length of postoperative hospital stays was statistically similar among the groups (P=0.849). The mean VAS score at 6h was significantly reduced in group I compared with group III (P=0.011). At 12h, the mean VAS score was significantly reduced in group I compared with group II and group III (P=0.009 and P<0.001). There was no significant difference in the mean VAS scores at 24h among three groups (P=0.920).
  
  
  CONCLUSIONS
  Lower insufflation pressures are associated with lower postoperative pain scores in the early postoperative period.
authors.affiliation: Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Akkoc
authors.affiliation: Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Ramazan
authors.initials: R
authors.lastname: Topaktas
authors.affiliation: Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Cemil
authors.initials: C
authors.lastname: Aydin
authors.affiliation: Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Selcuk
authors.initials: S
authors.lastname: Altin
authors.affiliation: Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey.
authors.forename: Reha
authors.initials: R
authors.lastname: Girgin
authors.affiliation: Department of Urology, Kartal Yavuz Selim State Hospital, Istanbul, Turkey.
authors.forename: Omer Faruk
authors.initials: OF
authors.lastname: Yagli
authors.affiliation: Department of Urology, Hitit University, Training and Research Hospital, Corum, Turkey.
authors.forename: Aykut Bugra
authors.initials: AB
authors.lastname: Sentürk
authors.affiliation: Department of Urology, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey.
authors.forename: Ahmet
authors.initials: A
authors.lastname: Metin
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007327:Insufflation / Q000379:methods*; D010535:Laparoscopy / Q000009:adverse effects / Q000295:instrumentation*; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000209:etiology / Q000517:prevention & control*; D011312:Pressure; D011446:Prospective Studies; D014421:Turkey; D013520:Urologic Surgical Procedures / Q000295:instrumentation*
keywords:  Pneumoperitoneum; Laparoscopy; Pain, Postoperative 