Simple Pulmonary Recruitment Maneuver To Reduce Shoulder Pain After Laparoscopic Cholecystectomy

Rabia Feroz, Muhammad Arsalan, Fariha Ashraf, Muhammad Faisal Ibrahim, Qamaruddin Baloch, Farhan Zaheer

Abstract

Objective

To determine the effectiveness of a simple pulmonary recruitment maneuver to reduce postoperative shoulder pain after laparoscopic cholecystectomy.

Study design

Quasi-experimental study.

Place & Duration of study

Department of Surgery, Dow Medical College, Ruth KM Pfau Civil Hospital Karachi, from August 2016 to August 2018.

Methodology

This study was conducted on 120 patients of either gender between 18 years to 60 years of age, admitted for laparoscopic cholecystectomy. Patients were divided into group A (control - n = 60) and group B (intervention - n = 60). The main outcome measure was postoperative shoulder pain assessed at 6, 12, 24 and 36 hours after laparoscopic cholecystectomy by using a visual analogue scale (VAS).

Results

The proportion of patients reporting shoulder pain in group B (38.3%) was significantly less than group A (68.3% -p = 0.002). The shoulder pain scores were markedly low (p<0.05) in group B than group A at 6 (2.13±1.05 compared with 3.24±1.72), 12 (4.87±0.814 compared with 6±2.35), 24 (2.35±1.26 compared with 3.44±1.8) and 36 (1±0.73 compared with 2.07±1.25) hours postoperatively. The mean VAS score of shoulder pain was significantly lower in group B than group A (2.59±0.53 versus 3.72±1.41 – p=0.000).

Conclusion

The simple pulmonary recruitment maneuver markedly reduced the postoperative shoulder pain after laparoscopic cholecystectomy.

Key words

Laparoscopic cholecystectomy, Postoperative shoulder Pain, Pulmonary recruitment maneuver.