A Study on Active Gas Aspiration to Reduce Pain after Laparoscopic Cholecystectomy

Vinayak, S Rengan (2019) A Study on Active Gas Aspiration to Reduce Pain after Laparoscopic Cholecystectomy. Masters thesis, Madras Medical College, Chennai.

[img]
Preview
Text
220100119vinayak_s_rengan.pdf

Download (3MB) | Preview
[img]
Preview
Text
220100119vinayak_s_rengan_abstract.pdf

Download (18kB) | Preview

Abstract

BACKGROUND: Laparoscopic cholecystectomy is one of the most common general surgical procedures performed in the world. Early post-operative shoulder and abdomen pain due to residual carbon-dioxide gas is a common problem. Active gas aspiration could be investigated as a possible means of resolving this issue. OBJECTIVES: 1. To evaluate the effect of active gas aspiration in patients undergoing Laparoscopic Cholecystectomy on shoulder pain and upper abdominal pain. 2. To evaluate the effect of active gas aspiration in patients undergoing Laparoscopic Cholecystectomy on hospitalisation durations. MATERIALS AND METHODS: Study Centre: Institute of General Surgery, Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai. Duration of Study: 1st October 2017 to 1st September 2018. Study Design: Randomised Control study. Single Blinding (Patient) Sample Size: 50 in each group {n = Z2 1-α/2 P(1-P) /e2 P=3% e= 5% Z=1.96}. INCLUSION CRITERIA: • All patients undergoing Laparoscopic Cholecystectomy for cholelithiasis between 20 to 85 years. EXCLUSION CRITERIA • ASA physical status of 3 and 4, • Pregnancy, • History of Drug /alcohol abuse, chronic painkiller support, • Active cholecystitis, • Malignancy, • Severe pre-operative pain, • Abnormal liver function tests, • Surgeries in which drains were used. Patients were divided into 2 groups, group Test/I (n=50) and group Control/II (n=50) randomly and with appropriate consent and information. All patients underwent a standard Laparoscopic Cholecystectomy. The intra-abdominal gas pressure was set at a level of 12mm Hg and monitored during the operation. Test group underwent active gas aspiration at the end of the procedure. RESULTS: Active gas aspiration did not produce any significant reduction in upper abdomen pain scores. However active gas aspiration produced significant pain reduction in shoulder pain scores at 8, 12 and 24 hrs. There was no difference in hospitalisation duration due to active gas aspiration at the end of Laparoscopic Cholecystectomy. In patients whose operating duration times exceeded 120 minutes,active gas aspiration did not produce any significant reduction in upper abdomen pain scores. In patients whose operating duration times exceeded 120 minutes, significant pain reduction in shoulder pain scores at 8, 12 and 24 hrs. Moreover, significant reduction hospitalisation duration was seen in the group which underwent active gas aspiration at the end of Laparoscopic Cholecystectomy. CONCLUSION: Active gas aspiration is an effective and simple means of reducing the CO2 gas in the sub-diaphragmatic space. It does not involve any extra cost. There is significant reduction in shoulder pain scores when active gas aspiration is performed. We advocate active gas aspiration at the end of Laparoscopic Cholecystectomy be adopted as a standard practice all over the world.

Item Type: Thesis (Masters)
Uncontrolled Keywords: shoulder pain, laparoscopic cholecystectomy, active gas aspiration, postoperative pain.
Subjects: MEDICAL > General Surgery
Depositing User: Subramani R
Date Deposited: 04 Sep 2019 00:47
Last Modified: 04 Sep 2019 00:47
URI: http://repository-tnmgrmu.ac.in/id/eprint/11453

Actions (login required)

View Item View Item