Postoperative Pain Reduction After Additional Intraperitoneal Suction Following Laparoscopic Cholecystectomy: A Prospective Randomized Controlled Study

Abstract

Objective: To compare postoperative pain between conventional CO₂ releasing method and additional suction after laparoscopic cholecystectomy (LC) considering PCA Morphine consumption which makes pain measurement more accurate than pain score.
Methods: Eligible patients with indication for LC were randomly assigned preoperatively either to have the conventional CO₂ releasing method, or an additional 60 seconds of suction after LC. We collected demographic data, postoperative pain at 6, 12 and 24 hours, residual intraperitoneal pressure, operative time, intraoperative Morphine amount and Morphine PCA amount in 24 hours. Pain evaluation by PCA amount was designed to get more accurate primary outcomes.
Results: The patients were similarly distributed. Residual intraperitoneal pressure was statistically significantly different. Morphine PCA amount in both groups were not significantly different. Postoperative pain level at 6, 12 and 24 hours as secondary outcomes showed that suction group seemed to have slightly higher pain score at 6 and 12 hours but at 24 hours post LC, pain in suction group tended to be a bit lower than in non-suction group.
Conclusion: Additional CO₂ suction from this study does not reduce postoperative pain. However, with a larger study population, it might help us to consider results in the intervention group better.