Active gas aspiration in reducing pain after laparoscopic cholecystectomy: a systematic review and meta-analysis of randomized controlled trials.

BACKGROUND: Postoperative pain is a common issue following laparoscopic cholecystectomy. This meta-analysis aimed to determine if active gas aspiration is more effective than passive gas aspiration in reducing postoperative pain and analgesic requirements. METHODOLOGY: The study conducted a systematic search of various databases, including Embase, Medline, and Cochrane Central Register of Controlled Trials (CENTRAL) via Ovid. It also searched trial registries and reference lists of included studies, with no date restrictions but limited to English language, up to December 21, 2022. The study included all randomized clinical trials that had documented elective laparoscopic cholecystectomy procedure and reported at least one relevant outcome. Articles that included subdiaphragmatic drain, intraperitoneal normal saline infusion, or pulmonary recruitment maneuver were excluded from the analysis. Two reviewers independently and in duplicate assessed the eligibility of studies and extracted data. The study reported findings according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. The risk of bias of the included trials was assessed using the Revised Cochrane Risk of Bias Assessment Tool. The study used a random-effects model to pool data. RESULTS: This meta-analysis included 5 randomized clinical trials with 367 participants and found that active gas aspiration resulted in significantly lower residual gas volume and total analgesia requirements compared to passive gas aspiration. Active gas aspiration also led to significantly lower shoulder pain scores at 24 h postoperatively. However, no significant differences were observed in hospital stay duration or abdominal pain scores. CONCLUSION: The study found that active gas aspiration can be effective in reducing postoperative shoulder pain and analgesic requirements after laparoscopic cholecystectomy, which has important implications for patient care and healthcare costs. Importantly, this intervention does not impose any additional time or financial burden. However, further research is needed to evaluate its impact on other laparoscopic procedures.

Satisfaction With the Use of Subdermal Contraceptive Implant in Women Attending the Specialized Polyclinic Primary Health Care Center in Jeddah City: A Cross-Sectional Study.

Background Subdermal contraceptive implants are a convenient method of contraception for many women due to the ease of insertion and removal and because they require less follow-up with their health facility. In addition to the contraceptive benefits, women's satisfaction with such devices is essential, as this can affect their quality of life. This study aims to measure women's satisfaction with the subdermal contraceptive implant, Implanon® (Organon & Co., Jersey City, New Jersey, United States), its main side effects, and reasons for removal.  Methods A cross-sectional study was conducted on women between the ages of 19 and 65 years who visited the Family Planning Clinic at the Specialized Polyclinic Primary Health Care Center in Jeddah, Saudi Arabia, between January 2018 and December 2021. An online questionnaire was distributed to the women who had Implanon inserted and 84 responded. Demographic and contraceptive data were collected, including the dates of insertion and removal of Implanon and side effects experienced while on Implanon.  Results Of the 84 women, 65.84% were satisfied with Implanon, while only 19.04% were unsatisfied with the implant. The most common side effect reported was weight gain (54.76%), followed by menstrual Irregularity. (39.29%). The most common reason for removal was the end of the implant's contraceptive duration (42.86%).  Conclusion Most of the women treated at this primary healthcare clinic were satisfied with Implanon. In addition, most of the women removed the implant only due to its reaching the end of its contraceptive duration despite experiencing side effects, and most women said that they would recommend it to their family and friends.