Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial

BMC Research Notes

Research Note

Mutasim Al-Ghazawi¹  Mahmoud Al-Said²  Shereen Sha’bin³  Shahed Halaseh³  Ghada Odeh³  Lana Al-Sabe³  Ikram Salameh³  Yousef B. Ahmad³  Tuqa Al-Ghazawi³  Mohammad Al-Qaisi⁴  Mohammad Rashdan⁵  Salam Daradkeh⁶  Azmi Mahafthah⁷  Jareer Heider Abuhmeidan⁸  Hanan Mansour⁹ 

[1] Department of Biopharmacutics and Clinical Pharmacy, The University of Jordan, Amman, Jordan;Department of Emergancy Medicine, School of Medicine, Jordan University Hospital, The University of Jordan, Amman, Jordan;Department of General Surgery, School of Medicine, Jordan University Hospital, The University of Jordan, Amman, Jordan;Department of General Surgery, School of Medicine, Jordan University Hospital, The University of Jordan, Amman, Jordan;King Hussein Cancer Center, Amman, Jordan;Department of General Surgery/ Minimally invasive surgery, School of Medicine, Jordan University Hospital, The University of Jordan, Amman, Jordan;Department of General Surgery/Hepatobiliary Division Jordan University Hospital, School of Medicine, The University of Jordan, Amman, Jordan;Department of Microbiology, School of Medicine, Jordan University Hospital, The University of Jordan, Amman, Jordan;Dr. Mohammed Alfagih Hospital, Riyadh, Saudi Arabia;King Hussein Cancer Center, Amman, Jordan;

关键词: Clinical trial;    Low pressure insufflation;    Pneumoperitoneum;    Laparoscopic cholecystectomy;    Pain;    Inflammatory marker;   

DOI  :  10.1186/s13104-023-06492-y

 received in 2023-03-15, accepted in 2023-09-03,  发布年份 2023

来源: Springer

【 摘 要 】

ObjectiveWe aim to assess the effect of low-pressure pneumoperitoneum on post operative pain and ten of the known inflammatory markers.BackgroundThe standard of care pneumoperitoneum set pressure in laparoscopic cholecystectomy is set to 12–14 mmHg, but many societies advocate to operate at the lowest pressure allowing adequate exposure of the operative field. Many trials have described the benefits of operating at a low-pressure pneumoperitoneum in terms of lower post operative pain, and better hemodynamic stability. But only few describe the effects on inflammatory markers and cytokines.MethodsA prospective, double-blinded, randomised, controlled clinical trial, including patients who underwent elective laparoscopic cholecystectomy. Patients randomised into low-pressure (8–10 mmHg) vs. standard-pressure (12–14 mmHg) with an allocation ratio of 1:1. Perioperative variables were collected and analysed.Resultsone hundred patients were allocated, 50 patients in each study arm. Low-pressure patients reported lower median pain score 6-hour post operatively (5 vs. 6, p-value = 0.021) in comparison with standard-pressure group. Eight out of 10 inflammatory markers demonstrated better results in low-pressure group in comparison with standard-pressure, but the effect was not statistically significant. Total operative time and surgery difficulty was not significantly different between the two groups even in the hands of inexperienced surgeons.Conclusionlow-pressure laparoscopic cholecystectomy is associated with less post operative pain and lower rise of inflammatory markers. It is feasible with comparable complications to the standard of care. Registered on ClinicalTrials.gov (NCT05530564/ September 7th, 2022).

【 授权许可】

CC BY   
© BioMed Central Ltd., part of Springer Nature 2023

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