Effects of Intraperitoneal Normal Saline and Bicarbonate Washing in Reduction of Postoperative Pain After Laparoscopic Cholecystectomy



Hajebi R¹ ; Siahkalmahalleh MR² ; Rezapour Y¹ ; Yazdi SAM¹ Show Affiliations
Source: Surgical Chronicles Published:2023

Abstract

Background: Pain after laparoscopic cholecystectomy is still important issue that prolonged hospitalization and also increased mortality and costs. One of the recent issues is intraperitoneal washing with a solution containing bicarbonate vials, as CO2 gas cause acidosis and pain after laparoscopic surgery. The aim of this study was to evaluate the effect of intraperitoneal washing with normal saline in combination with bicarbonate on postoperative pain in patients undergoing laparoscopic cholecystectomy. Methods: This clinical trial was performed in patients who underwent laparoscopic cholecystectomy with the installation of 4 trocars. Patients were randomly divided into two groups. In group A (52 patients), patients receive intraperitoneal normal saline (20 cc / kg) and Bicarbonate (8.4% 50mEq/50mL (1mEq/mL) 50mL VIAL) at the end of surgery. In group B (49 patients), patients did not receive any intraperitoneal washing. Pain was assessed using visual analog scale (VAS) 2, 6 and 24 hours and also 1 week after surgery in right and left shoulder tip, umbilical, epigastric, midclavicular and right flank trocars. Results: Demographic characteristics of patients in each group including gender and age was equal. Based on this study, postoperative pain was significantly lower in case group in right and left shoulder tip, umbilical and epigastric trocars 2 and 24 hours after surgery and in midclavicular and right flank trocars 2 hour and 1 week after surgery (P>0.05). Also, demand dose of analgesia was lower in sodium bicarbonate group. Conclusions: Intraperitoneal washing with sodium bicarbonate is an effective method that reduce pain after laparoscopic cholecystectomy. © 2023 Surgical Society of Northern Greece. All rights reserved.