Effects of warm carbon dioxide insufflation vs. local heat on shoulder pain in laparoscopic cholecystectomy: A randomized clinical trial

Objective

Laparoscopic cholecystectomy is a common procedure for gallbladder diseases, but many patients experience shoulder pain due to pneumoperitoneum. This study investigates the comparative effectiveness of warm carbon dioxide gas insufflation versus local heat application in reducing shoulder pain after laparoscopic cholecystectomy. We also examined changes in body temperature during surgery and postoperative shivering in the intervention and control groups.

Methods

93 patients undergoing elective laparoscopic cholecystectomy were divided into three groups: Group A: Warm carbon dioxide gas, Group B: Local heat, Group C: Control. Patients' body temperature, shivering, and right/left shoulder pain were evaluated. Data was analyzed using SPSS software with a significance level of 0.05 and GEE regression.

Results

Mean right shoulder pain scores at 48 h and mean left shoulder pain scores at 24/48 h post-operation were significantly lower in the intervention groups compared to control (p < 0.05). There were differences in temperature body during surgery among the study groups. The mean body temperature was 0.48 units higher in Group B compared to the control group. Group A had a 0.14-unit lower temperature than the control group, although this difference was not statistically significant. No significant difference in postoperative shivering was observed among the groups.

Conclusion

Based on the findings of this study, Methods of warm carbon dioxide gas insufflation and local heating in laparoscopic cholecystectomy reduce shoulder pain in patients during the postoperative phase. The local heating method significantly increased the patients' body temperature compared to the other two groups, and shivering was similar across all three groups.