Chung Ji Won, Kang Kyu Sik, Park Sang Hyun, Kim Chun Sook, Chung Jin Hun, Yoo Sie Hyeon, Kim Nan Seol, Seo Yong Han, Jung Ho Soon, Chun Hea Rim, Gong Hyung Youn, Jung Hae Il, Bae Sang Ho, Park Su Yeon
Department of Anesthesiology and Pain Medicine, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Department of Surgery, Soonchunhyang University Cheonan Hospital, Cheonan, Korea.
Ann Surg Treat Res. 2017 Oct;93(4):181-185. doi: 10.4174/astr.2017.93.4.181. Epub 2017 Sep 28.
This study set out to identify the association between the intraperitoneal CO concentrations and postoperative pain by dividing the participants into a control group and 2 experimental groups receiving irrigation (1 L and 2 L), and directly measuring their intraperitoneal CO concentrations with a CO gas detector.
A total of 101 patients, American Society of Anesthesiologists physical status classification I and II patients aged 18-65 years were enrolled in the study. Group 1 did not receive irrigation with normal saline, while groups 2 and 3 were administered irrigation with 1 L and 2 L of normal saline, respectively, after laparoscopic cholecystectomy. Intraperitoneal CO concentrations were measured with a CO gas detector through the port, and postoperative pain was assessed on a visual analogue scale at 6, 12, and 24 hours after surgery.
The intraperitoneal CO concentrations were 1,016.0 ± 960.3 ppm in group 1, 524.5 ± 383.2 ppm in group 2, and 362.2 ± 293.6 ppm in group 3, showing significantly lower concentrations in groups 2 and 3. Postoperative pain was significantly lower in group 3 at 6 hours after surgery, and in groups 2 and 3 at 12 hours after the surgery. However, there was no significant difference between the 3 groups in postoperative pain 24 hours after the surgery.
This study found a causal relationship between the amount of normal saline used for irrigation and the intraperitoneal CO concentrations in that irrigation with normal saline reduces pain on the day of the surgery.
本研究旨在通过将参与者分为对照组和两个接受冲洗（1升和2升）的实验组，并使用一氧化碳气体探测器直接测量其腹腔内一氧化碳浓度，来确定腹腔内一氧化碳浓度与术后疼痛之间的关联。
本研究共纳入101例美国麻醉医师协会身体状况分级为I级和II级、年龄在18至65岁之间的患者。第1组未接受生理盐水冲洗，而第2组和第3组在腹腔镜胆囊切除术后分别接受1升和2升生理盐水冲洗。通过端口使用一氧化碳气体探测器测量腹腔内一氧化碳浓度，并在术后6、12和24小时采用视觉模拟评分法评估术后疼痛情况。
第1组腹腔内一氧化碳浓度为1016.0±960.3 ppm，第2组为524.5±383.2 ppm，第3组为362.2±293.6 ppm，第2组和第3组的浓度明显较低。术后6小时第3组的术后疼痛明显较低，术后12小时第2组和第3组的术后疼痛明显较低。然而，术后24小时三组之间的术后疼痛没有显著差异。
本研究发现用于冲洗的生理盐水用量与腹腔内一氧化碳浓度之间存在因果关系，即生理盐水冲洗可减轻手术当天的疼痛。
