期刊
LANGENBECKS ARCHIVES OF SURGERY
卷 408, 期 1, 页码 -出版社
SPRINGER
DOI: 10.1007/s00423-023-02988-0
关键词
Low-pressure pneumoperitoneum; Robotic surgical procedures; Cholecystectomy; Shoulder pain
类别
This study investigated the effect of extremely low-pressure pneumoperitoneum (ELPP) compared to standard pressure pneumoperitoneum (SPP) on postoperative pain, shoulder pain, and physiological changes during single-site robotic cholecystectomy (SSRC). The results showed that the ELPP group had lower postoperative pain scores, fewer patients with shoulder pain, and less intraoperative changes in lung function.
PurposeA robotic platform has enabled extremely low-pressure pneumoperitoneum (ELPP, 4 mmHg) to reduce surgical insults to human physiology during a minimally invasive surgery. The objective of this study was to investigate the effect of ELPP in single-site robotic cholecystectomy (SSRC) on postoperative pain, shoulder pain, and physiological changes during surgery compared to a standard pressure pneumoperitoneum (SPP, 12-14 mmHg).MethodsA total of 182 patients who underwent an elective cholecystectomy were randomized into an ELPP SSRC group (n = 91) and an SPP SSRC group (n = 91). Postoperative pain was assessed at 6, 12, 24, and 48 h after surgery. The number of patients complaining of shoulder pain was observed. Intraoperative changes of ventilatory parameters were also measured.ResultsPostoperative pain scores (p = 0.038, p < 0.001, p < 0.001, and p = 0.015 at 6, 12, 24, and 48 h after surgery, respectively) and the number of patients with shoulder pain (p <0.001) were significantly lower in the ELPP SSRC group than in the SPP SSRC group. Intraoperative changes in peak inspiratory pressure (p < 0.001), plateau pressure (p < 0.001), EtCO2 (p < 0.001), and lung compliance (p < 0.001) were also less in the ELPP SSRC group.ConclusionThe ELPP during robotic cholecystectomy could significantly relieve postoperative pain and shoulder pain. In addition, the ELPP can reduce changes in lung compliance during surgery and the demand for postoperative analgesics, thereby improving the quality of life of patients during early stages of postoperative rehabilitation.
作者
我是这篇论文的作者
点击您的名字以认领此论文并将其添加到您的个人资料中。
推荐
暂无数据