Comparison of the effect of warm saline irrigation versus negative gas suction on reduction of postoperative pain in patients of laparoscopic cholecystectomy

ABSTRACT OBJECTIVE: To compare warm saline irrigation and negative gas suction in terms of frequency of severe postoperative pain in patients of laparoscopic cholecystectomy. PATIENTS AND METHODS: A comparative clinical trial was conducted in the Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad over a period of six months. After ethical approval from the hospital ethics committee, all patients who had laparoscopic cholecystectomy for gallstones were enrolled in the study. Patients were randomly divided into two equal groups by lottery methods. One group had warm saline irrigation of the operative field while the other group had negative gas suction at the end of the procedure. The pain score was recorded postoperatively by visual analog score. SPSS version 21 was used for descriptive analysis of the variables. RESULTS: A total of 102 patients were included according to the study's inclusion criteria. All the patients were observed for 24 hours for severe postoperative pain. The mean age (years) of the patients was 40.40+11.55 years. There were 28 (27.5%) male and 74 (72.5%) female patients in the study. The frequency of severe postoperative pain in patients of laparoscopic cholecystectomy among warm saline irrigation and negative gas suction was 33 (64.7%) and 14 (24.5%) respectively which was statistically significant (p-value ˂0.001). CONCLUSION: Patients in the negative gas suction group have better modalities in reducing severe postoperative pain after laparoscopic cholecystectomy. This helps in early pain relief that reduces the agony of the patients and shortens the post-operative hospital stay. KEYWORDS: Cholelithiasis, Laparoscopic Cholecystectomy, Postoperative Pain