Intraperitoneal instillation of normal saline to decrease shoulder pain following laparoscopic cholecystectomy

Abstract EN

Background and Objectives Although laparoscopic cholecystectomy (LC) significantly reduces postoperative pain and provides satisfaction for both the patient and the surgeon, still there is some discomfort which is experienced by some patients either as shoulder pain or abdominal pain.

The aim was to measure the efficacy of intraperitoneal instillation of the normal saline in reducing shoulder pain.

Methods This is a prospective study, 120 patients who underwent laparoscopic cholecystectomy were randomly divided to four groups.

In the group A: no intraperitoneal instillation of normal saline was used and no drain was left in a subhepatic region.

In the second group B: no intraperitoneal instillation of normal saline was used but a sub hepatic drain was left for 24 hours.

In the group C :intraperitoneal instillation of normal saline under the right hemidiaphragm and beneath the liver intraoperatively with aspiration at the end of operation.

In the group D: the same steps of group C were used but a sub hepatic drain left for 24 hours.

Postoperatively shoulder pain score was recorded on a visual analogue scale during 2,6,12,24,48,72 hours postoperatively and any additional analgesic requirements were recorded.

Results Shoulder pain score revealed a significant decrease in group C and D versus controls A and B at 2,6,12,24,48,72 hours postoperatively .(p value = 0.01) also Analgesic requirements for shoulder pain were less in groups C and D after surgery compared to that in group A and B.

Conclusion: Intraperitoneal instillation of normal saline can reduce postoperative shoulder pain after laparoscopic cholecystectomy