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Omalgia postcolecistectomìa laparoscópica en pacientes aleatorizados de los hospitales Vicente Corral Moscoso y José Carrasco Arteaga. 2013

Abstract:

Objective: to determine the intensity of shoulder pain associated with laparoscopic cholecystectomy with pneumoperitoneum pressure of 12 mmHg in the Vicente Corral Moscoso and José Carrasco Arteaga hospital. Methodology: study controlled clinical trial. It was considered a universe to patients who were admitted for elective laparoscopic cholecystectomy in the Vicente Corral Moscoso and José Carrasco Arteaga hospitals. Sample: it is calculated with IC of 95%. Statistics power 80%, shoulder pain postlaparoscopic cholecystectomy of 35% of the control group and 20% in the intervention group. Ratio 1:1. Plus 10% for losses. By applying the formula of sample for two proportions in Epi Info 7 version 2011. n:110 patients for each group, total 220 patients. In Group 1, control: laparoscopic cholecystectomy with pneumoperitoneum with 12 mmHg of CO2. In Group 2, intervention: laparoscopic cholecystectomy with pneumoperitoneum with 15 mmHg of CO2. Results: The average age in the group with 12 mmHg or less of CO2 pressure was 44,81 years with a DE of 17,55 years; while in the other group was 45,97 years old with a DE 17,55 years; the prevalence of shoulder pain in the group of patients with 12 mmHg of CO2 pressure (Group 1) was 28.2%, while in the group that received a pressure of 15 mmHg with CO2 (Group 2) the prevalence of omalgia was 46.4; (CO2 pressure was associated with the presentation of pain at 2,6,12,18 and 24 hours (Chi-square and significant p-value); low pressure (12 mmHg) is beneficial for the presentation of moderate or severe pain with a RR at 2 hours of 0.21 (0, 1-0, 4) at 6 hours 0.43 (0, 2-0, 7); at 12 hours 0.61 (0, 4-0, 9); at 18 hours 0.26 (0, 1-0, 5) and at 24 hours 0.41 (0, 1-1, 1). Conclusions: A pneumoperitoneum with low pressure (12 mmHg) is beneficial than high-pressure (15 mmHg) in the appearance of shoulder pain and tin he intensity of it. Keywords: LAPAROSCOPIC CHOLECYSTECTOMY, SHOULDER PAIN, PNEUMOPERITONEUM