Shoulder Tip Pain Following the Release of Pneumoperitoneum in Supine Versus Trendelenburg Position After Laparoscopic Cholecystectomy: A Comparative Study

Muhammad Arslan, S. H. Waqar

Abstract

Objective

To compare the intensity of shoulder tip pain and patients’ satisfaction following the release of pneumoperitoneum in supine versus Trendelenburg position after laparoscopic cholecystectomy.

Study design

Cross sectional comparative study.

Place & Duration of study

Department of General Surgery, Pakistan Institute of Medical Sciences Islamabad, from January 2022 to October 2022.

Methods

Patients between 25 years -75 years of age who underwent laparoscopic cholecystectomy were included. Postoperatively patients were divided into two groups. In group A, the release of carbon dioxide was done in supine and in Group B, Trendelenburg position. The shoulder tip pain was recorded at 4, 8, 12, and 24-hours after surgery by using visual analog scale (VAS). A score of < 3, at the end of final assessment of pain was considered as satisfactory. Data were analyzed using SPSS 22 software. Chi-square test was applied for statistical significance.

Results

A total of 60 patients were included. The mean age of the patients was 47.10±14.11 years. In Group A, the mean VAS score was 2.27±1.41 and in Group B, 1.40±1.37. This was statistically significant ((p=0.019). In Group A, 13 (43.3%) and in Group B, 23 (76.7%) patients reported as being satisfied (p=0.008), an indicator of effectiveness of the position maintained for the release of pneumoperitoneum.

Conclusion

The release of pneumoperitoneum in Trendelenburg position was found superior in comparison with the supine position as it resulted in significantly less pain in postoperative period.

Key words

Laparoscopic cholecystectomy, Trendelenburg position, Pneumoperitoneum, Pain, Visual analog scale.