Postoperative pain relief after laparoscopic cholecystectomy: intraperitoneal sodium bicarbonate versus normal saline
Gastroenterology and Hepatology from Bed to Bench,
Vol. 9 No. 3 (2016),
20 June 2016
,
Page 189-196
https://doi.org/10.22037/ghfbb.v0i0.870
Abstract
Aim: The aim of this study was to determine the effect of sodium bicarbonate irrigation versus normal saline irrigation in patients undergoing a laparoscopic cholecystectomy.
Background: Pain in patients undergoing laparoscopic cholecystectomy is the most common complaint, especially in the abdomen, back, and shoulder region.
Patients and methods: In a double blind randomized clinical trial, 150 patients were assigned to the three groups (50 patients in each group). Group A received intraperitoneal irrigation normal saline (NS). Groups B and C received irrigation sodium bicarbonate and none irrigation, respectively. Pain was assessed using a visual analog scale (VAS) for 6, 18 and 24 hours postoperatively, as well as one week after the surgery. Data analysis was performed using SPSS ver18 and chi-square, Fisher’s Exact Test, on-way ANOVA and repeated measure ANOVA tests.
Results: Patients in groups showed no significant difference in terms of age, gender, past medical history and smoking history (p>0.05). Left shoulder tip pain was significantly lower only between the sodium bicarbonate group and non-washing group at 6, 18, and 24 hours postoperatively (P=0.04, P=0.02 and P=0.009 respectively). There was no significant difference between the three treatment groups in right shoulder tip pain, back pain and port site incisional pain.
Conclusion: In laparoscopic cholecystectomy, peritoneal irrigation with sodium bicarbonate may reduce the intensity of postoperative shoulder tip pain and is an effective method for improving the quality of life within the early recovery period.
- Sodium bicarbonate
- Intraperitoneal irrigation
- Laparoscopic cholecystectomy
- Post operative pain.
How to Cite
References
Barkun JS, Wexler MJ, Hinchey EJ, et al. Laparoscopic versus open inguinal herniorrhaphy: preliminary results of a randomized controlled trial. Surgery 1995; 118:703–710.
Buanes T, Mjaland O. Complications in laparoscopic and open cholecystectomy: a prospective comparative trial. Surg Laparosc Endosc Percutan Tech 1996; 6:266–272.
Mendoza-Sagaon M, Hanly EJ, Talamini MA, et al. Comparison of the stress response after laparoscopic and open cholecystectomy. Surg Endosc 2000; 14:1136–1141.
Jatzko GR, Lisborg PH, Pertl AM, et al. Multivariate comparison of complications after laparoscopic cholecystectomy and open cholecystectomy. Ann Surg 1995; 221:381–386.
Boddy AP, Mehta S, Rhodes M. The effect of intraperitoneal local anesthesia in laparoscopic cholecystectomy: a systematic review and meta-analysis. Anesth Analg 2006; 103:682-8.
Bisgaard T, Kehlet H, Rosenberg J. Pain and convalescence after laparoscopic cholecystectomy. Ann R Coll Surg Engl 2001; 167:84–96.
Bisgaard T, Klarskov B, Rosenberg J, et al. Factors determining convalescence after uncomplicated laparoscopic cholecystectomy. Arch Surg 2001; 136:917–921.
Jackson SA, Laurence AS, Hill JC. Does post-laparoscopy pain relate to residual carbon dioxide? Anaesthesia 1996; 51:485-7.
Mouton WG, Bessell JR, Otten KT, et al. Pain after laparoscopy. Surg Endosc 1999; 13:445-8.
Tsimoyiannis EC, Siakas P, Tassis A, et al. Intraperitoneal normal saline infusion for postoperative pain after laparoscopic cholecystectomy.World J Surg 1998; 22:824-8.
Madsen MR, Jensen KEJ. Postoperative pain and nausea after laparoscopic cholecystectomy. Surg Laparosc Endosc 1992; 2:303–305
Joris J,Thiry E, Paris P, et al. Pain after laparoscopic cholecystectomy: characteristics and effect of intraperitoneal bupivacaine. Anesth Analg 1995; 81:379-384.
Helvacioglu A, Weis R. Operative laparoscopy and postoperative pain relief. Fertil Steril 1992; 57:548–552.
Knolmayer TJ, Bowyer MW, Egan JC, et al. The effects of pneumoperitoneum on gastric blood flow and traditional hemodynamic measurements. Surg Endosc 1998; 12:115–118.
Volz J, Koster S, Spacek Z, et al. Characteristic alterations of the peritoneum after carbon dioxide pneumoperitoneum. Surg Endosc 1999; 13:611–614.
Wildbrett P, Oh A, Naundorf D, et al. Impact of laparoscopic gases on peritoneal microenvironment and essential parameters of cell function. Surg Endosc 2003; 17:78–82.
Wong YT, Shah PC, Birkett DH, et al. Carbon dioxide pneumoperitoneum causes severe peritoneal acidosis, unaltered by heating, humidification, or bicarbonate in a porcine model. Surg Endosc 2004; 18:1498-503.
Pier A, Benedic M, Mann B, Buck V. Das postlaparoskopische Schmerzsyndrom. Chirurg 1994; 65:200–208.
Bisgaard T, Klarskov B, Rosenberg J, et al. Characteristics and prediction of early pain after laparoscopic cholecystectomy. Pain 2001; 90:261–269.
Barczyński M, Herman RM. Low-pressure pneumoperitoneum combined with intraperitoneal saline washout for reduction of pain afterlaparoscopic cholecystectomy: a prospective randomized study.Surg Endosc 2004; 18:1368-73.
Jabbour-Khoury SI, Dabbous AS, Gerges FJ,et al. Intraperitoneal and intravenous routes for pain relief in laparoscopic cholecystectomy. JSLS 2005; 9:316-21.
Castillo-Garza G, Díaz-Elizondo JA, Cuello-García CA et al. Irrigation with bupivacaine at the surgical bed for postoperative pain relief after laparoscopic cholecystectomy. JSLS 2012; 16:105-11.
- Abstract Viewed: 295 times
- PDF Downloaded: 206 times