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The influence of the pulmonary recruitment maneuver on post-laparoscopic shoulder pain in patients having a laparoscopic cholecystectomy: a randomized controlled trial

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Abstract

Background

Post-laparoscopic shoulder pain is very common after laparoscopy. One method to reduce postoperative shoulder pain is the pulmonary recruitment maneuver. It is used to reduce post-laparoscopic shoulder pain. This study utilizes a truly experimental, double-blinded, prospective randomized design to assess the effect of pulmonary recruitment maneuvers on post-laparoscopic shoulder pain after laparoscopic cholecystectomy.

Methods

Sixty patients were allocated randomly into two groups. The intervention group received five manual pulmonary inflations for 5 s at a maximum pressure of 25 cm H2O. The control group included patients whose residual CO2 gas was evacuated from the abdominal cavity using passive exsufflation as the routine method at the end of surgery by abdominal massage. Gentle abdominal pressure was applied to facilitate CO2 gas removal.

Results

When Ramsay's Sedation Score’s results were compared between the two groups after the operation, there was no statistically significant difference between the two groups during the first and (p value = 0.20) second (p value = 0.61) hours. A repeated measures ANOVA revealed that the pulmonary recruitment maneuver is significant (p-value 0.001) and had a high effect size (0.527) in reducing shoulder pain among laparoscopic cholecystectomy patients after controlling the effect of other covariate patient characteristics.

Conclusion

Utilizing a pulmonary recruitment maneuver at the end of laparoscopic surgery reduces shoulder pain.

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Funding

Nothing to declare.

Author information

Authors and Affiliations

  1. CRNA, NICU, Rafidia Hospital, Palestinian Ministry of Health, Nablus, Palestine

    Bushra Mousa Samarah & Fatema Amer Shehada

  2. Faculty of Medicine and Health Sciences, An-Najah National University, PO Box 7, Nablus, Palestine

    Jamal Qaddumi

  3. Nablus, Palestine

    Nour Aldin Almasry

  4. Faculty of Nursing, Jerash University, Jerash, Jordan

    Nisser Alhroub

  5. Bachelor of Medicine and Surgery, Ministry of Health, Irbid, Jordan

    Bayan ALBashtawy

  6. Faculty of Nursing, Jordan University of Science and Technology, Irbid, Jordan

    Khitam Mohammad

  7. Bachelor of Medicine and Surgery, Irbid, Jordan

    Sa’d ALBashtawy

  8. Department of Community and Mental Health, Princess Salma Faculty of Nursing, AL Al-Bayt University, Mafraq, Jordan

    Abdullah Alkhawaldeh, Mohammed ALBashtawy & Ma’en Aljezawi

  9. Faculty of Nursing, Sultan Qaboos University, Muscat, Oman

    Omar Al Omari

  10. Department of Maternal and Child Health, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan

    Shereen Hamadneh

  11. Community and Mental Health Department, Princess Salma Faculty of Nursing, Al al-Bayt University, Mafraq, Jordan

    Mohammad Suliman

  12. Faculty of Nursing, Irbid National University, Irbid, Jordan

    Salam Bani Hani

  13. Faculty of Medicine, Yarmouk University, Irbid, Jordan

    Zaid ALBashtawy

Authors
  1. Bushra Mousa Samarah
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  2. Fatema Amer Shehada
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  3. Jamal Qaddumi
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  4. Nour Aldin Almasry
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  5. Nisser Alhroub
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  6. Bayan ALBashtawy
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  7. Khitam Mohammad
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  8. Sa’d ALBashtawy
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  9. Abdullah Alkhawaldeh
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  10. Mohammed ALBashtawy
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  11. Omar Al Omari
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  12. Ma’en Aljezawi
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  13. Shereen Hamadneh
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  14. Mohammad Suliman
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  15. Salam Bani Hani
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  16. Zaid ALBashtawy
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Corresponding author

Correspondence to Salam Bani Hani.

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Disclosures

All authors agreed with the publication process and Bushra Mousa Samarah, Fatema Amer Shehada, Jamal Qaddumi, Nour Aldin Almasry, Nisser Alhroub, Bayan ALBashtawy, Khitam Mohammad, Sa'd ALBashtawy, Abdullah Alkhawaldeh, Mohammed ALBashtawy, Omar Al Omari, Ma'en Aljezawi, Shereen Hamadneh, Mohammad Suliman, Salam Bani Hani, and Zaid ALBashtawy have no conflicts of interest or financial ties to disclose.

Ethical approval

This study was approved by the institutional review board of An-Najah National University before the first patient enrollment.

Informed consent

Written informed consent was obtained from all patients participating in this study.

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Samarah, B.M., Shehada, F.A., Qaddumi, J. et al. The influence of the pulmonary recruitment maneuver on post-laparoscopic shoulder pain in patients having a laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 37, 8473–8482 (2023). https://doi.org/10.1007/s00464-023-10450-x

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  • DOI: https://doi.org/10.1007/s00464-023-10450-x

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