Samarah Bushra Mousa, Shehada Fatema Amer, Qaddumi Jamal, Almasry Nour Aldin, Alhroub Nisser, ALBashtawy Bayan, Mohammad Khitam, ALBashtawy Sa'd, Alkhawaldeh Abdullah, ALBashtawy Mohammed, Al Omari Omar, Aljezawi Ma'en, Hamadneh Shereen, Suliman Mohammad, Hani Salam Bani, ALBashtawy Zaid
CRNA, NICU, Rafidia Hospital, Palestinian Ministry of Health, Nablus, Palestine.
Faculty of Medicine and Health Sciences, An-Najah National University, PO Box 7, Nablus, Palestine.
Surg Endosc. 2023 Nov;37(11):8473-8482. doi: 10.1007/s00464-023-10450-x. Epub 2023 Sep 26.
Post-laparoscopic shoulder pain is very common after laparoscopy. One method to reduce postoperative shoulder pain is the pulmonary recruitment maneuver. It is used to reduce post-laparoscopic shoulder pain. This study utilizes a truly experimental, double-blinded, prospective randomized design to assess the effect of pulmonary recruitment maneuvers on post-laparoscopic shoulder pain after laparoscopic cholecystectomy.
Sixty patients were allocated randomly into two groups. The intervention group received five manual pulmonary inflations for 5 s at a maximum pressure of 25 cm HO. The control group included patients whose residual CO gas was evacuated from the abdominal cavity using passive exsufflation as the routine method at the end of surgery by abdominal massage. Gentle abdominal pressure was applied to facilitate CO gas removal.
When Ramsay's Sedation Score's results were compared between the two groups after the operation, there was no statistically significant difference between the two groups during the first and (p value = 0.20) second (p value = 0.61) hours. A repeated measures ANOVA revealed that the pulmonary recruitment maneuver is significant (p-value 0.001) and had a high effect size (0.527) in reducing shoulder pain among laparoscopic cholecystectomy patients after controlling the effect of other covariate patient characteristics.
Utilizing a pulmonary recruitment maneuver at the end of laparoscopic surgery reduces shoulder pain.
腹腔镜术后肩痛在腹腔镜手术后非常常见。一种减轻术后肩痛的方法是肺复张手法。它用于减轻腹腔镜术后肩痛。本研究采用真正的实验性、双盲、前瞻性随机设计，以评估肺复张手法对腹腔镜胆囊切除术后腹腔镜术后肩痛的影响。
60例患者随机分为两组。干预组接受5次手动肺充气，每次5秒，最大压力为25cm水柱。对照组包括在手术结束时通过腹部按摩采用常规方法被动排气将腹腔内残留的二氧化碳气体排出的患者。施加轻柔的腹部压力以促进二氧化碳气体排出。
术后比较两组的 Ramsay 镇静评分结果，在术后第一小时（p值 = 0.20）和第二小时（p值 = 0.61）两组之间无统计学显著差异。重复测量方差分析显示，在控制其他协变量患者特征的影响后，肺复张手法在减轻腹腔镜胆囊切除术后患者的肩痛方面具有显著性（p值0.001）且效应量较高（0.527）。
在腹腔镜手术结束时采用肺复张手法可减轻肩痛。
