Introduction:- Insufation of carbon dioxide during laparoscopic cholecystectomy carries on to
postoperative shoulder tip pain. The beginning of shoulder pain is commonly presumed to be due to
overstretching of the diaphragmatic muscle bres due to high carbon dioxide pressure.
Methods: - Patients came and admitted to the surgery department for elective cholecystectomy were enrolled in the study. The
patients were randomly divided in two groups (group A and group B). In group A - low-pressure pneumoperitoneum (8 mm Hg)
and in group B- standard pressure pneumoperitoneum (14 mm Hg) was created during laparoscopic cholecystectomy.
Postoperative shoulder tip pain was evaluated at 4 hours and 24 hours after the operation.
Results:- Fourteen patients or 28 % of patients in group B complained of postoperative shoulder tip pain as collated to only ve
patients (10%) in group A. The mean intensity of postoperative shoulder tip pain assessed by the visual analogue scoring scale
at 4 hours and 24 hours was less in group A as collated to group B. However, statistical signicance was seen only at four hours.
Analgesic requirements and the mean length of postoperative stay in the hospital were minor in group-A as collated to group B.
Conclusion: - Low-pressure laparoscopic cholecystectomy signicantly reduces the frequency and intensity of postoperative
shoulder tip pain. Low-pressure laparoscopic cholecystectomy decreases the demand for postoperative analgesics, decreases
postoperative hospital stay, and improves the quality of life in the initial stage of postoperative rehabilitation.
Randomized Trial of Low-pressure Carbon Dioxide-elicited Pneumoperitoneum Versus Abdominal Wall Lifting for Laparoscopic Cholecystectomy