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. 2017 Oct;93(4):181-185.
doi: 10.4174/astr.2017.93.4.181. Epub 2017 Sep 28.

Effect of intraperitoneal CO2 concentration on postoperative pain after laparoscopic cholecystectomy

Ji Won Chung  1 , Kyu Sik Kang  1 , Sang Hyun Park  1 , Chun Sook Kim  1 , Jin Hun Chung  1 , Sie Hyeon Yoo  1 , Nan Seol Kim  1 , Yong Han Seo  1 , Ho Soon Jung  1 , Hea Rim Chun  1 , Hyung Youn Gong  1 , Hae Il Jung  2 , Sang Ho Bae  2 , Su Yeon Park  3
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Effect of intraperitoneal CO2 concentration on postoperative pain after laparoscopic cholecystectomy

Ji Won Chung et al. Ann Surg Treat Res. 2017 Oct.

Abstract

Purpose: This study set out to identify the association between the intraperitoneal CO2 concentrations and postoperative pain by dividing the participants into a control group and 2 experimental groups receiving irrigation (1 L and 2 L), and directly measuring their intraperitoneal CO2 concentrations with a CO2 gas detector.

Methods: A total of 101 patients, American Society of Anesthesiologists physical status classification I and II patients aged 18-65 years were enrolled in the study. Group 1 did not receive irrigation with normal saline, while groups 2 and 3 were administered irrigation with 1 L and 2 L of normal saline, respectively, after laparoscopic cholecystectomy. Intraperitoneal CO2 concentrations were measured with a CO2 gas detector through the port, and postoperative pain was assessed on a visual analogue scale at 6, 12, and 24 hours after surgery.

Results: The intraperitoneal CO2 concentrations were 1,016.0 ± 960.3 ppm in group 1, 524.5 ± 383.2 ppm in group 2, and 362.2 ± 293.6 ppm in group 3, showing significantly lower concentrations in groups 2 and 3. Postoperative pain was significantly lower in group 3 at 6 hours after surgery, and in groups 2 and 3 at 12 hours after the surgery. However, there was no significant difference between the 3 groups in postoperative pain 24 hours after the surgery.

Conclusion: This study found a causal relationship between the amount of normal saline used for irrigation and the intraperitoneal CO2 concentrations in that irrigation with normal saline reduces pain on the day of the surgery.

Keywords: Carbon dioxide gas detector; Intraperitoneal carbon dioxide; Postoperative period pain; Saline waters.

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Conflict of interest statement

CONFLICTS OF INTEREST: No potential conflict of interest relevant to this article was reported.

Figures

Fig. 1
Fig. 1. VAS for postoperative pain at 6, 12, and 24 hours after laparoscpic cholecystectomy. And difference of intra-abdominal CO2 concentration among 3 groups. G1, no irrigation group; G2, 1-L irrigation group; G3, 2-L irrigation group.
See this image and copyright information in PMC

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