NDLI: Effect of low-pressure pneumoperitoneum on pain and inflammation in laparoscopic cholecystectomy: a randomized controlled clinical trial

Content Provider	Springer Nature : BioMed Central
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
Abstract	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).
Related Links	https://bmcresnotes.biomedcentral.com/counter/pdf/10.1186/s13104-023-06492-y.pdf
Ending Page	10
Page Count	10
Starting Page	1
File Format	HTM / HTML
ISSN	17560500
DOI	10.1186/s13104-023-06492-y
Journal	BMC Research Notes
Issue Number	1
Volume Number	16
Language	English
Publisher	BioMed Central
Publisher Date	2023-09-28
Access Restriction	Open
Subject Keyword	Biomedicine Medicine Public Health Life Sciences Clinical trial Low pressure insufflation Pneumoperitoneum Laparoscopic cholecystectomy Pain Inflammatory marker Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Biochemistry, Genetics and Molecular Biology Medicine
Journal Impact Factor	1.6/2023

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