LOW-PRESSURE PNEUMOPERITONEUM : A MODALITY TO REDUCE SHOULDER-TIP PAIN AND HEM ODYNAMIC CONSEQUENCES AFTER LAPAROSCOPIC GYNECOLOGIC SURGERY
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Laparoscopic gynecologic surgery (LOS) is an advantageous procedure that widely replaced the traditional open laparotomy especially for diagnostic purposes. However, high-pressure pneumoperitoneum was accused for precipitating some intraoperative hemodynamic effects and postoperative shoulder-tip pain (STP). The objectives of this study were to determine the influence of low-pressure pneurnoperitoneum on the frequency and intensity of shoulder-tip pain and body hernodynarnics in patients undergoing LOS. The study comprised 87 female patients divided into two study groups: Group I. comprised 49 femniP assigned to undergo LOS under high-pressure (13-15 mmHg) and 38 patients under lowpressure (7-9 rrunHg) (Group II). Intraoperative monitoring inch wird measurement of heart rate (HR), systolic and diastolic blood pressure, and mean arterial blood pressure (MAP) was calculated. The frequency of postoperative STP was determined and its intensity was determined using visual analogue scale charts (VAS). There was a significant (Pc0.05) increase in MAP in both groups at 5 min after insufflat ion, but there was a significant decrease of MAP in Group II as compared to Group I (X2=7.716, P<0.05). There was a significant reduction of both frequency (15.8% vs. 26.5%) and intensity of STP in low-pressure group compared to high-pressure group. This difference was especially significant 6,12,24 hours postoperatively. Moreover there was a positive significant correla- tion between the insuffiated pressure and the frequency (r=0.691.