Chang Wonbin, Yoo Tae, Cho Won Tae, Cho Giyuon
Department of Surgery, Hallym University College of Medicine, Hwaseong, Korea.
Ann Surg Treat Res. 2021 May;100(5):276-281. doi: 10.4174/astr.2021.100.5.276. Epub 2021 Apr 29.
This study aims to evaluate the effect of different pneumoperitoneum pressures on postoperative pain, especially by subcategorizing the pressures into 3 groups during laparoscopic cholecystectomy (LC).
We conducted a prospective randomized, double-blinded study of 150 patients with benign and uncomplicated gallbladder disease. They were categorized into 3 groups. Each group (50 patients) underwent LC with different pneumoperitoneum methods: group VLP, very-low pressure (6-8 mmHg); group LP, low pressure (9-11 mmHg); and group SP, standard pressure (12-14 mmHg). The 3 groups were compared for pain intensity, duration, analgesic requirement, and complications.
The characteristics of the patients were similar among all groups. Postoperative pain scores at each time point (1, 2, 4, 6, 12, 24, and 48 hours) were not significantly different among the 3 groups. Further, operation time, hospital stay, the number of analgesic consumption doses, and postoperative complications were not significantly different among the 3 groups.
This study demonstrates no difference in postoperative pain among various pneumoperitoneum pressures during LC. Therefore, routine use of lower-pressure pneumoperitoneum is not recommended unless in selected patients who require low-pressure pneumoperitoneum surgery.
本研究旨在评估不同气腹压力对术后疼痛的影响，尤其是在腹腔镜胆囊切除术（LC）期间将压力分为3组进行亚分类研究。
我们对150例患有良性且无并发症胆囊疾病的患者进行了一项前瞻性随机双盲研究。他们被分为3组。每组（50例患者）采用不同的气腹方法进行LC：VLP组，极低压力（6 - 8 mmHg）；LP组，低压力（9 - 11 mmHg）；SP组，标准压力（12 - 14 mmHg）。比较3组的疼痛强度、持续时间、镇痛需求和并发症情况。
所有组患者的特征相似。3组在各时间点（1、2、4、6、12、24和48小时）的术后疼痛评分无显著差异。此外，3组之间的手术时间、住院时间、镇痛药物消耗剂量数和术后并发症无显著差异。
本研究表明，LC期间不同气腹压力下术后疼痛无差异。因此，除非是需要低压气腹手术的特定患者，不建议常规使用低压气腹。
