Comparative Study Between Low-Pressure Versus Standard- Pressure Pneumoperitoneum on Shoulder Pain After Laparoscopic Surgery

Abstract

Background: Shoulder pain is a frequent postoperative complication following laparoscopic surgery, often resulting from diaphragmatic irritation due to residual CO2 in the abdominal cavity. Different methods have been explored to alleviate this pain, and one promising approach is lowering the pneumoperitoneum pressure during surgery.

Objective: To assess the impact of low-pressure pneumoperitoneum (8-10 mmHg) compared to standard-pressure pneumoperitoneum (12-15 mmHg) on the occurrence and intensity of shoulder pain after laparoscopic surgery.

Methodology: A comparative study was conducted between July 2022 and January 2024. A total of 100 patients undergoing laparoscopic surgery were randomly divided into two groups: low-pressure (n = 50) and standard-pressure (n = 50) pneumoperitoneum. The primary outcome was the Visual Analog Scale (VAS) score for shoulder pain at 6, 12, and 24 hours post-surgery. Statistical analysis was performed with a significance level set at p < 0.05.

Results: The low-pressure group had significantly lower VAS scores at all postoperative time points. The 24-hour mean VAS score was 2.3 ± 0.7 for the low-pressure group, compared to 4.2 ± 1.1 in the standard-pressure group (p < 0.05).

Conclusion: Low-pressure pneumoperitoneum significantly reduces postoperative shoulder pain, suggesting that it can be a preferred method in laparoscopic surgeries to improve patient comfort.