Rajneesh K, Ankur H, Subhash G and Ramandeep Singh W
Background: Shoulder tip pain after laparoscopic procedures is common leading to patient’s distress, delayed discharge.
Objective: To evaluate simple and effective intervention to reduce incidence of shoulder tip pain after laparoscopic cholecystectomy.
Setting: Tertiary care medical college.
Materials and methods: Eighty patients of cholelithiasis were included in study and aim of study will compare incidence of shoulder tip pain in two groups of 40 each. Group A (Study group) received thorough intraperitoneal saline wash and in Group B (Control group), no saline wash will be done. We intend to thoroughly wash the peritoneal cavity after the removing all blood clots and debris with 0.9% normal saline till clear fluid is seen in the cavity. Postoperative pain was assessed by visual analogue scale at fixed time intervals.
Results: When VAS score was analysed in two groups. Study group add less score as compared to control group, though statistically insignificant (P>0.05), reduction of incidence of shoulder tip pain was found within 24 hours post-operatively. This shows that incidence of shoulder tip pain after laparoscopic cholecystectomy was reduced by intraperitoneal wash. Additional analgesic requirement was significantly less in study group (P=0.005) at 1 hour after surgery, highly significant (p=0.000) up to 6 hours and again significant at 6-12 hours post-operatively (p=0.005). Analgesic requirement though reduced in study group at 12-24 hours but not statistically significant (p=0.338).
Conclusion: Intraperitoneal saline wash was effective in decreasing shoulder tip pain after laparoscopic cholecystectomy.