Ali Zahedian, Mohsen Shoja , Hadi Mollazade, Masoomeh Taiebi ,
Volume 72, Issue 2 (May 2014)
Abstract
Background: Laparoscopic cholecystectomy is a way of removing the gallbladder. But like other surgeries, this procedure has some side effects such as postoperative shoulder pain. This study evaluates the effect of different gas flow rates into the abdominal cavity on postoperative shoulder pain in laparoscopic cholecystectomy patients.
Methods: The study as a randomized clinical trial was conducted on laparoscopic chol-ecystectomy patients in Imam Khomeini Hospital- Esfarayen 2011-2012. One hun-dred participants were selected by available sampling, and were divided randomly into two groups of 50 patients. In group I flow rate of CO2 gas was two liters per minute and in group II flow rate of CO2 gas was five liters per minute. After reversing anesthe-sia, six, 12 and 24 hours post operative, shoulder pain was evaluated by Visual Ana-logue Scale (VAS) pain questionnaire. The study findings analyzed by independent t-test.
Results: The mean age of participants was 48.8±7.5 years and mean surgery duration was 36.5±13.1 minutes, and there was no significant differences between two groups (P>0/05). However, the mean shoulder pain scores in group I (blowing with low pres-sure) was differed significantly with group II (blowing with high pressure) (P<0.05). In group I, pain was lower than group II.
Conclusion: Results showed if CO2 gas flow rate is two liters per minute (blowing with low pressure), the patients complain less shoulder pain. Therefore low pressure gas in-sufflation for laparoscopic surgery is recommended. Further studies in this field should be considered.
Shahram Seyfi, Ali Zahedian , Farshad Hasanzadeh Kiabi,
Volume 75, Issue 2 (May 2017)
Abstract
Background: Postoperative pain is one of the most common complications following laparoscopic cholecystectomy. Because the majority of the analgesic drugs including opioids and nonsteroidal anti-inflammatory drugs have many side effects, using drugs with lesser side effects is beneficial. The aim of this study was to evaluate the effect of N-acetylcysteine on the pain after laparoscopic cholecystectomy.
Methods: In a randomized clinical trial, in two university-affiliated teaching hospitals in Babol City (Shahid Beheshti and Shahid Yahyanezhad Hospitals), Iran, from August 2015 to March 2015, a total number of 38 patients with age of 20-50 years, who were candidates for laparoscopic cholecystectomy with American Society of Anesthesiologists Class-I were chosen and randomly assigned into two groups. The night before operation, 1200 mg oral N-acetylcysteine is given to intervention group. Also, they received 600 mg IV N-acetylcysteine in the morning before operation. In the control group, two vitamin C effervescent tablets as placebo were given at night before operation and 3 ml sterile water as placebo was injected in the morning of operation. Amount of pethidine consumption and the changes in hemodynamic in two groups was recorded and analyzed at 24 hours after operation.
|
Results: The average of patients age was not significant different between two groups (P=0.23). Average of pain score in placebo group was 3.5 and in N-acetylcysteine group was 2.7 that it was not significant difference between two groups (P=0.06). Average of pethidine consumption in placebo group was 52 mg and in N-acetylcysteine group was 29 mg in 24 hours, that the difference was statistically significant between two groups (P=0.01)
Conclusion: As the results of the study, it can be concluded that the anti-inflammatory effects N- acetylcysteine can inhibit the function of lipoproteins and prostaglandins, reduced glutathione peroxidase and dismutase has been restored and can be used to treat pain or analgesic dose reduction. In this study the N-acetylcysteine has reduced pain after laparoscopy and analgesic dose of mepridine.
|
