COMPARATIVE STUDY OF FLUCTUATIONS IN HEMODYNAMIC PARAMETERS USING DIFFERENT INTRA-ABDOMINAL PRESSURES IN LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

INTRODUCTION: Laparoscopic cholecystectomy decreases postoperative pain, decreases the need for postoperative analgesia, returns the patient to full activity within 1 week (compared with 1 month after open cholecystectomy), discharged the day after surgery. This study was conducted to compare the uctuations in hemodynamic changes using different intra- abdominal pressures with CO2 in laparoscopic cholecystectomy. MATERIALS AND METHODS: Thisrandomised, prospective, interventional study was conducted in Durgapur Steel Plant Hospital, Durgapur, West Bengal from November 2018 to January 2020. In our study, we attempted to compare the uctuations in hemodynamic changes using different intra- abdominal pressures. Present study included 90 cases undergoing laparoscopic cholecystectomy who were randomly divided into 3 groups with different intra-abdominal pressures, maintained during surgical intervention by CO2 insufation. RESULT: Mean VAS score was 2.83 in group Aafter 6 hours of laparoscopic cholecystectomy which decreased to 2.13 and 0.07 by the end of 12 and 24 hours respectively. The mean VAS scores for group B and C were 5.87; 8.03, 4.33; 7.10 and 2.40; 5.93 at 6, 12 and 24 hours post laparoscopic cholecystectomy respectively. Mean VAS score was signicantly lower in group A as compared to group B and lower in group B as compared to group C respectively at all time intervals (p<0.01). CONCLUSION: Low intra-abdominal pressures during surgical intervention by CO2 insufation leads to better hemodynamic control, better pain management and decreased hospital stay. Present study thus recommends use of low pressure pneumoperitoneum in all cases undergoing laparoscopic cholecystectomy.