Zárate SD, Suárez PH, Ibarrola BAE, Bolaños AR, Chaya HM

Language: Spanish
References: 12
Page: 246-250
PDF size: 202.92 Kb.

ABSTRACT

Introduction: Abdominal and shoulder pain are frequent complications of laparoscopic surgery. This pain results from diaphragmatic and phrenic nerve irritation by the pneumoperitoneum with CO₂ . Objective: Determine if using low pneumoperitenum pressures during gynecologic laparoscopic procedures results in a lower incidence and severity of this complication. Material and methods: We prospectively evaluated 63 patients undergoing gynecologic laparoscopic procedures (42 minor procedures and 21 hysterectomies), subdividing them according to whether a low- (8-10 mmHg) or standard-pressure (12-15 mmHg) pneumoperitoneum was used. Variables such as frequency and severity of pain, operative time and surgical bleeding were analyzed. Results: No differences in the incidence or severity of abdominal or shoulder pain were noted between those patients subjected to minor procedures with low pressure (n = 22) or standard pressure (n = 20) pneumoperitoneum. Among patients who underwent hysterectomy, the incidence and severity of abdominal and shoulder pain were lower in those in whom the procedure was performed with low-pressure pneumoperitoneum (n = 15) than in those using standard pressures (n = 6). Intraoperative bleeding was slightly higher in those operated with low pressures. Conclusions: The use of low-pressure pneumiperitoneum during gynecologic laparoscopic surgery results in a lower incidence and severity of shoulder and abdominal pain in patients undergoing hysterectomy but not in those undergoing minor procedures.

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