Peritoneal limited conditioning reduces postoperative pain: a randomized controlled trial in robot-assisted laparoscopic myomectomy
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- 作者：Nathalie Storme ; Stefaan Pacquée ; Michèle Ampe ; An Creemers…
- 刊名：Gynecological Surgery
- 出版年：2016
- 出版时间：August 2016
- 年：2016
- 卷：13
- 期：3
- 页码：139-146
- 全文大小：487 KB
- 刊物主题：Gynecology; Minimally Invasive Surgery; Surgical Oncology; Obstetrics/Perinatology; Reproductive Medicine; Interventional Radiology;
- 出版者：Springer Berlin Heidelberg
- ISSN：1613-2084
- 卷排序：13
文摘
Postoperative pain is related to the gas used for laparoscopy as demonstrated for 100 % nitrous oxide in 2002 by Tsereteli. In a previous trial, we demonstrated that the use of full conditioning adding 10 % nitrous oxide and 4 % oxygen to the CO2 pneumoperitoneum with humidification and altering the temperature of the insufflation gas, the use of Hyalobarrier gel, and the administration of 5 mg dexamethasone significantly reduced postoperative pain and decreased adhesions. As we believed that just altering the insufflation gas by adding 10 % of nitrous oxide and 4 % of oxygen would reduce pain and adhesions by itself, we performed a randomized controlled trial on women undergoing robot-assisted laparoscopic myomectomy. Fourteen women undergoing robot-assisted laparoscopic myomectomy were randomized 1:1 receiving 86 % CO2 + 10 % N2O + 4 % O2 or 100 % CO2. Outcome parameters were postoperative pain (visual analog scale (VAS)) and adhesions observed at second-look laparoscopy after 14 days. Pain and painkiller intake were significantly reduced by using the altered insufflation gas (p < 0.05). Adhesions did not show a significant difference, although the study group tended to have less adhesions (p < 0.21). Addition of 10 % N2O and 4 % O2 to the pneumoperitoneum significantly decreased postoperative pain, even in a low number of participants, which suggests a strong effect.KeywordsConditioningGasLaparoscopyPainPneumoperitoneumMyomectomy