Evaluation of the Carbon Dioxide Insufflation rate on shoulder pain after Laparoscopic Cholecystectomy

Introduction: shoulder pain following laparoscopic surgery is one of the common complaints in these patients. There are many reasons to justify shoulder pain following the inhalation of carbon dioxide during laparoscopic surgery. In the present study, the effect of different CO2 insufflation rates on laparoscopic cholecystectomy on shoulder pain was investigated. Materials and methods: in this clinical trial study, 26 patients with gallbladder candidate for laparoscopic cholecystectomy who met the inclusion criteria were selected using convenience sampling and randomly divided into two groups of 13 each. The first group was "case" (high CO2 flow rate: 7.5 L/min) and the second group was "control" (low CO2 gas flow rate: 2.5 L/min) were divided. Shoulder pain at 1, 6, 12 and 24 after surgery was compared with verbal rating scale and frequency of opiate analgesic seeking in the first 24 hours. Result: according to the results of the present study, the shoulder pain scores in the case group compared to the control group (6.38 +/- 3.15 vs. 3.69 +/- 1.75 and p=0.006) and also at 1 o'clock (2.69 +/- %75 vs. 2.00 +/- 1.00 and p=0.029) and 12 o'clock (1.15 +/- 1.21 vs. %38 +/- %65 and p=0.029) postoperatively it was significantly higher than the control group. Frequency of analgesic application at 24 hours postoperatively was significantly higher in case group than in control group (1.38 +/- 1.04 vs. %76 +/- %59 and p=0.036). Conclusion: Patients feel less shoulder pain if carbon dioxide gas is injected into the abdominal cavity, therefore, for laparoscopic cholecystectomy, low-speed gas blowing is recommended.