Ec. Tsimoyiannis et al., INTRAPERITONEAL NORMAL SALINE INFUSION FOR POSTOPERATIVE PAIN AFTER LAPAROSCOPIC CHOLECYSTECTOMY, World journal of surgery, 22(8), 1998, pp. 824-828
After laparoscopic surgery carbon dioxide remains within the peritonea
l cavity for a few days, commonly causing pain. This prospective rando
mized study was performed to determine the efficacy of intraperitoneal
infusion of normal saline on postoperative pain after laparoscopic ch
olecystectomy. Altogether 300 patients were randomly assigned to one o
f five groups of 60 patients each. Group A: control group, no peritone
al infusion, no subhepatic drain. Group B: no peritoneal infusion but
a subhepatic closed drain was left for 24 hours. Group C: normal salin
e 25 to 30 ml/kg body weight at a temperature of 37 degrees C was infu
sed under the right hemidiaphragm and left in the peritoneal cavity, G
roup D: normal saline in a room temperature was infused under the righ
t hemidiaphragm and suctioned after the pneumoperitoneum was deflated.
Group E: normal saline was infused and suctioned as in group D, but a
subhepatic closed drain was left for 24 hours. Postoperatively, analg
esic medication usage, nausea, vomiting, and pain scores mere determin
ed at 2, 6, 12, 24, 48, and 72 hours (during hospitalization and at. h
ome). Postoperative pain was reduced significantly (p < 0.001) in the
patients of groups C, D, and E versus controls, whereas no difference
was observed between groups A and B. Among groups C, D, and E, group E
(p, < 0.01) had the best results followed by group D and then group C
. Intraperitoneal normal saline offered a detectable benefit to patien
ts undergoing laparoscopic cholecystectomy The beneficial effect was b
etter when the fluid was suctioned after deflation of the pneumoperito
neum and even better when a subhepatic closed drain continued fluid su
ction during the first postoperative hours.