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Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial
OBJECTIVE: We aim to assess the effect of low-pressure pneumoperitoneum on post operative pain and ten of the known inflammatory markers. BACKGROUND: The standard of care pneumoperitoneum set pressure in laparoscopic cholecystectomy is set to 12–14 mmHg, but many societies advocate to operate at the...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540329/ https://www.ncbi.nlm.nih.gov/pubmed/37770908 http://dx.doi.org/10.1186/s13104-023-06492-y |
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author | Rashdan, Mohammad Daradkeh, Salam Al-Ghazawi, Mutasim Abuhmeidan, Jareer Heider Mahafthah, Azmi Odeh, Ghada Al-Qaisi, Mohammad Salameh, Ikram Halaseh, Shahed Al-Sabe, Lana Ahmad, Yousef B. Al-Ghazawi, Tuqa Al-Said, Mahmoud Sha’bin, Shereen Mansour, Hanan |
author_facet | Rashdan, Mohammad Daradkeh, Salam Al-Ghazawi, Mutasim Abuhmeidan, Jareer Heider Mahafthah, Azmi Odeh, Ghada Al-Qaisi, Mohammad Salameh, Ikram Halaseh, Shahed Al-Sabe, Lana Ahmad, Yousef B. Al-Ghazawi, Tuqa Al-Said, Mahmoud Sha’bin, Shereen Mansour, Hanan |
author_sort | Rashdan, Mohammad |
collection | PubMed |
description | OBJECTIVE: We aim to assess the effect of low-pressure pneumoperitoneum on post operative pain and ten of the known inflammatory markers. BACKGROUND: The standard of care pneumoperitoneum set pressure in laparoscopic cholecystectomy is set to 12–14 mmHg, but many societies advocate to operate at the lowest pressure allowing adequate exposure of the operative field. Many trials have described the benefits of operating at a low-pressure pneumoperitoneum in terms of lower post operative pain, and better hemodynamic stability. But only few describe the effects on inflammatory markers and cytokines. METHODS: A prospective, double-blinded, randomised, controlled clinical trial, including patients who underwent elective laparoscopic cholecystectomy. Patients randomised into low-pressure (8–10 mmHg) vs. standard-pressure (12–14 mmHg) with an allocation ratio of 1:1. Perioperative variables were collected and analysed. RESULTS: one hundred patients were allocated, 50 patients in each study arm. Low-pressure patients reported lower median pain score 6-hour post operatively (5 vs. 6, p-value = 0.021) in comparison with standard-pressure group. Eight out of 10 inflammatory markers demonstrated better results in low-pressure group in comparison with standard-pressure, but the effect was not statistically significant. Total operative time and surgery difficulty was not significantly different between the two groups even in the hands of inexperienced surgeons. CONCLUSION: low-pressure laparoscopic cholecystectomy is associated with less post operative pain and lower rise of inflammatory markers. It is feasible with comparable complications to the standard of care. Registered on ClinicalTrials.gov (NCT05530564/ September 7th, 2022). |
format | Online Article Text |
id | pubmed-10540329 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-105403292023-09-30 Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial Rashdan, Mohammad Daradkeh, Salam Al-Ghazawi, Mutasim Abuhmeidan, Jareer Heider Mahafthah, Azmi Odeh, Ghada Al-Qaisi, Mohammad Salameh, Ikram Halaseh, Shahed Al-Sabe, Lana Ahmad, Yousef B. Al-Ghazawi, Tuqa Al-Said, Mahmoud Sha’bin, Shereen Mansour, Hanan BMC Res Notes Research Note OBJECTIVE: We aim to assess the effect of low-pressure pneumoperitoneum on post operative pain and ten of the known inflammatory markers. BACKGROUND: The standard of care pneumoperitoneum set pressure in laparoscopic cholecystectomy is set to 12–14 mmHg, but many societies advocate to operate at the lowest pressure allowing adequate exposure of the operative field. Many trials have described the benefits of operating at a low-pressure pneumoperitoneum in terms of lower post operative pain, and better hemodynamic stability. But only few describe the effects on inflammatory markers and cytokines. METHODS: A prospective, double-blinded, randomised, controlled clinical trial, including patients who underwent elective laparoscopic cholecystectomy. Patients randomised into low-pressure (8–10 mmHg) vs. standard-pressure (12–14 mmHg) with an allocation ratio of 1:1. Perioperative variables were collected and analysed. RESULTS: one hundred patients were allocated, 50 patients in each study arm. Low-pressure patients reported lower median pain score 6-hour post operatively (5 vs. 6, p-value = 0.021) in comparison with standard-pressure group. Eight out of 10 inflammatory markers demonstrated better results in low-pressure group in comparison with standard-pressure, but the effect was not statistically significant. Total operative time and surgery difficulty was not significantly different between the two groups even in the hands of inexperienced surgeons. CONCLUSION: low-pressure laparoscopic cholecystectomy is associated with less post operative pain and lower rise of inflammatory markers. It is feasible with comparable complications to the standard of care. Registered on ClinicalTrials.gov (NCT05530564/ September 7th, 2022). BioMed Central 2023-09-28 /pmc/articles/PMC10540329/ /pubmed/37770908 http://dx.doi.org/10.1186/s13104-023-06492-y Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Note Rashdan, Mohammad Daradkeh, Salam Al-Ghazawi, Mutasim Abuhmeidan, Jareer Heider Mahafthah, Azmi Odeh, Ghada Al-Qaisi, Mohammad Salameh, Ikram Halaseh, Shahed Al-Sabe, Lana Ahmad, Yousef B. Al-Ghazawi, Tuqa Al-Said, Mahmoud Sha’bin, Shereen Mansour, Hanan Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial |
title | Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial |
title_full | Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial |
title_fullStr | Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial |
title_full_unstemmed | Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial |
title_short | Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial |
title_sort | effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial |
topic | Research Note |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540329/ https://www.ncbi.nlm.nih.gov/pubmed/37770908 http://dx.doi.org/10.1186/s13104-023-06492-y |
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