Mohammadzade A R, Esmaili F
1Department of Surgery, Velayat Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.
Velayat Clinical Research Development Unit, Velayat Hospital, 22 Bahman Blvd, P.O.BOX 34719-76161, Qazvin, Iran.
Indian J Surg. 2018 Feb;80(1):30-35. doi: 10.1007/s12262-016-1552-4. Epub 2016 Oct 28.
The laparoscopic cholecystectomy (LC) is the gold standard to treat gallstone. To view the surgical site in this type of operations better, carbon dioxide is used with a certain pressure. The current study aimed to compare the hemodynamic symptoms and the level of abdominal pain due to using high- and low-pressure carbon dioxide in patients undergoing LC. The current double-blind randomized clinical trial was conducted on 60 patients with the age range of 20-70 years old undergoing LC. The first and second groups experienced PaCO of 7-10 and 12-14 mmHg, respectively. The hemodynamic symptoms, abdominal pain, shoulder-tip pain, nausea and vomiting after the surgery, and the mean of liver function tests were evaluated. Data were analyzed using test, Chi-square test, and repeated measures ANOVA by SPSS 16. Information of 60 patients in two groups was analyzed. There was a significant difference between the groups regarding the mean of systolic blood pressure ( < 0.05). The mean of heart rate was significantly higher in the high-pressure group during surgery and 1 h after that ( < 0.05). The frequency of pain in shoulder-tip and abdomen was higher in the high-pressure group. Frequency of nausea and vomiting 12 h after the surgery between two groups was significant ( < 0.05). The mean of alkaline phosphatase was higher in the low-pressure group than the high-pressure group ( < 0.05). Considering the good performance and low side effects of low-pressure laparoscopic cholecystectomy compared to those of high-pressure, this method can be replaced by high-pressure in LC.
腹腔镜胆囊切除术(LC)是治疗胆结石的金标准。为了在这类手术中更好地观察手术部位,会使用一定压力的二氧化碳。本研究旨在比较在接受LC的患者中使用高、低压二氧化碳时的血流动力学症状和腹痛程度。本双盲随机临床试验对60例年龄在20至70岁之间接受LC的患者进行。第一组和第二组分别经历7至-10 mmHg和12至14 mmHg的呼气末二氧化碳分压(PaCO₂)。评估了血流动力学症状、术后腹痛、肩部疼痛、恶心和呕吐以及肝功能测试平均值。使用SPSS 16通过t检验、卡方检验和重复测量方差分析对数据进行分析。分析了两组60例患者的信息。两组间收缩压平均值存在显著差异(P<0.05)。高压组在手术期间及术后1小时心率平均值显著更高(P<0.05)。高压组肩部和腹部疼痛频率更高。两组术后12小时恶心和呕吐频率存在显著差异(P<0.05)。低压组碱性磷酸酶平均值高于高压组(P<0.05)。考虑到与高压腹腔镜胆囊切除术相比,低压腹腔镜胆囊切除术性能良好且副作用小,在LC中该方法可替代高压法。