A randomized control study to evaluate the effect of Positive end-expiratory pressure and post-operative Incentive spirometry for reduction of right shoulder Tip pain after laparoscopic cholecystectomy and Appendectomy

Abstract

Introduction: Laparoscopic surgery is the mainstay of treatment for the diseases of the appendix and gallbladder.Although laparoscopy has proved its superiority over laparotomy in terms of postoperative pain scores,Postoperative right shoulder tip pain remains a major concern.Post-laparoscopy right Shoulder tip pain is reported to occur in 35 to 70 percent of the patients. The pain can be severe and disturbs the patient's quality of life on the first postoperative day. The mechanisms behind the post laparoscopic right shoulder tip pain are due to the Residual carbon dioxide present in the abdominal cavity which causes irritation of the phrenic nerve and referred pain to the shoulders. With the help of Positive end-expiratory pressure [PEEP] and Incentive spirometry [IS], The incidence of post laparoscopy Right shoulder tip pain can be reduced. Aims and Objective: To find the Postoperative Right shoulder pain reduction with the use of Positive end-expiratory pressure and incentive spirometry and The incidence of the Right shoulder tip pain post-Laparoscopy.