Which intraperitoneal insufflation pressure should be used for less postoperative pain in transperitoneal laparoscopic urologic surgeries?

Vol. 43 (3): 518-524, May – June, 2017

doi: 10.1590/S1677-5538.IBJU.2016.0366


ORIGINAL ARTICLE

Ali Akkoc 1, Ramazan Topaktas 1, Cemil Aydin 1, Selcuk Altin 1, Reha Girgin 1, Omer Faruk Yagli 2, Aykut Bugra Sentürk 3, Ahmet Metin 4
1 Department of Urology, Gazi Yasargil Training and Research Hospital, Diyarbakir, Turkey; 2 Department of Urology, Kartal Yavuz Selim State Hospital, Istanbul, Turkey; 3 Department of Urology, Hitit University, Training and Research Hospital, Corum, Turkey; 4 Department of Urology, Abant Izzet Baysal University Faculty of Medicine, Bolu, Turkey

ABSTRACT

Purpose: To determine whether using different intraperitoneal insufflation pressures for transperitoneal laparoscopic urologic surgeries decreases postoperative pain.
Materials and Methods: 76 patients who underwent transperitoneal laparoscopic up¬per urinary tract surgery at different insufflation pressures were allocated into the following groups: 10mmHg (group I, n=24), 12mmHg (group II, n=25) and 14mmHg (group III, n=27). These patients were compared according to age, gender, body mass index (BMI), type and duration of surgery, intraoperative bleeding volume, postopera¬tive pain score and length of hospital stay. A visual analog scale (VAS) was used for postoperative pain.
Results: Demographic characteristics, mean age, gender, BMI and type of surgeries were statistically similar among the groups. The mean operation time was higher in group I than group II and group III but this was not statistically significant (P=0.810). The mean intraoperative bleeding volume was significantly higher in group I compared with group II and group III (P=0.030 and P=0.006). The mean length of postoperative hospital stays was statistically similar among the groups (P=0.849). The mean VAS score at 6h was significantly reduced in group I compared with group III (P=0.011). At 12h, the mean VAS score was significantly reduced in group I compared with group II and group III (P=0.009 and P<0.001). There was no significant difference in the mean VAS scores at 24h among three groups (P=0.920).
Conclusion: Lower insufflation pressures are associated with lower postoperative pain scores in the early postoperative period.

Keywords:  Pain, Postoperative; Pneumoperitoneum; Laparoscopy; Urology

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