Comparing Hemodynamic Symptoms and the Level of Abdominal Pain in High- Versus Low-Pressure Carbon Dioxide in Patients Undergoing Laparoscopic Cholecystectomy

The laparoscopic cholecystectomy (LC) is the gold standard to treat gallstone. To view the surgical site in this type of operations better, carbon dioxide is used with a certain pressure. The current study aimed to compare the hemodynamic symptoms and the level of abdominal pain due to using high- and low-pressure carbon dioxide in patients undergoing LC. The current double-blind randomized clinical trial was conducted on 60 patients with the age range of 20–70 years old undergoing LC. The first and second groups experienced PaCO₂ of 7–10 and 12–14 mmHg, respectively. The hemodynamic symptoms, abdominal pain, shoulder-tip pain, nausea and vomiting after the surgery, and the mean of liver function tests were evaluated. Data were analyzed using T test, Chi-square test, and repeated measures ANOVA by SPSS 16. Information of 60 patients in two groups was analyzed. There was a significant difference between the groups regarding the mean of systolic blood pressure (P < 0.05). The mean of heart rate was significantly higher in the high-pressure group during surgery and 1 h after that (P < 0.05). The frequency of pain in shoulder-tip and abdomen was higher in the high-pressure group. Frequency of nausea and vomiting 12 h after the surgery between two groups was significant (P < 0.05). The mean of alkaline phosphatase was higher in the low-pressure group than the high-pressure group (P < 0.05). Considering the good performance and low side effects of low-pressure laparoscopic cholecystectomy compared to those of high-pressure, this method can be replaced by high-pressure in LC.