After laparoscopic surgery
carbon dioxide remains within the peritoneal cavity for a few days, commonly causing
pain. This prospective randomized study was performed to determine the efficacy of
intraperitoneal infusion of
normal saline on
postoperative pain after
laparoscopic cholecystectomy. Altogether 300 patients were randomly assigned to one of five groups of 60 patients each. Group A: control group, no
peritoneal infusion, no subhepatic drain. Group B: no
peritoneal infusion but a subhepatic closed brain was left for 24 hours. Group C:
normal saline 25 to 30 ml/kg
body weight at a temperature of 37 degrees C was infused under the right hemidiaphragm and left in the peritoneal cavity. Group D:
normal saline in a room temperature was infused under the right hemidiaphragm and suctioned after the
pneumoperitoneum was deflated. Group E:
normal saline was infused and suctioned as in group D, but a subhepatic closed drain was left for 24 hours. Postoperatively,
analgesic medication usage,
nausea,
vomiting, and
pain scores were determined at 2, 6, 12, 24, 48, and 72 hours (during hospitalization and at home).
Postoperative pain was reduced significantly (p < 0.001) in the patients of groups C, D, and E versus controls, whereas no difference was observed between groups A and B. Among groups C < D and E, group E (p < 0.01) had the best results followed by group D and then group C. Intraperitoneal
normal saline offered a detectable benefit to patients undergoing
laparoscopic cholecystectomy. The beneficial effect was better when the fluid was suctioned after deflation of the
pneumoperitoneum and even better when a subhepatic closed drain continued fluid suction during the first postoperative hours.