Rabia Feroz, Muhammad Arsalan, Fariha Ashraf, Muhammad Faisal Ibrahim, Qamaruddin Baloch, Farhan Zaheer.
Simple Pulmonary Recruitment Maneuver to Reduce Shoulder Pain after Laparoscopic Cholecystectomy.
J Surg Pak Jan ;25(4):163-7.

Objective: to determine the effectiveness of a simple pulmonary recruitment maneuver to reduce postoperative shoulder pain after laparoscopic cholecystectomy. Study design: Quasi-experimental study. Place & Duration of study: Department of Surgery, Dow Medical College, Ruth KM Pfau Civil Hospital Karachi, from August 2016 to August 2018. Methodology: This study was conducted on 120 patients of either gender between 18 years to 60 years of age, admitted for laparoscopic cholecystectomy. Patients were divided into group A (control - n = 60) and group B (intervention - n = 60). The main outcome measure was postoperative shoulder pain assessed at 6, 12, 24 and 36 hours after laparoscopic cholecystectomy by using a visual analogue scale (VAS). Results: The proportion of patients reporting shoulder pain in group B (38.3%) was significantly less than group A (68.3% -p = 0.002). The shoulder pain scores were markedly low (p<0.05) in group B than group A at 6 (2.13+-1.05 compared with 3.24+-1.72), 12 (4.87+-0.814 compared with 6+-2.35), 24 (2.35+-1.26 compared with 3.44+-1.8) and 36 (1+-0.73 compared with 2.07+-1.25) hours postoperatively. The mean VAS score of shoulder pain was significantly lower in group B than group A (2.59+-0.53 versus 3.72+-1.41 - p=0.000). Conclusion: The simple pulmonary recruitment maneuver markedly reduced the postoperative shoulder pain after laparoscopic cholecystectomy.

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