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J Gynecol Obstet Hum Reprod ; 46(2): 155-158, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28403972

RESUMO

OBJECTIVES: To evaluate feasibility of performing benign gynecologic pathology low pressure (7mmHg) laparoscopy (LPL) with AirSeal® system and to study benefits in terms of postoperative pain, when compared to a standard insufflation group (15mmHg). MATERIALS AND METHODS: In this prospective randomized pilot study, 60 patients had laparoscopy for gynecologic benign pathology: 30 with 7mmHg and AirSeal system, and 30 with 15mmHg standard insufflator. The primary endpoint was incidence of shoulder pain. A postoperative questionnaire was completed by each patient to assess shoulder pain (Numeric Rating Scale [NRS], from 0 to 10) at H4, H8, H24, and consumption of morphinics was notified. During each procedure, anesthesia parameters were collected (peak airway pressure, systolic blood pressure, end tidal CO2). RESULTS: Laparoscopy was performed on 30 patients in AirSeal®-LP group without need to increase pressure above 7mmHg, and no complication was reported. Incidence of shoulder pain was significantly lower in the AirSeal®-LP group (23.3% vs. 73.3%, P<0.001). NRS shoulder pain was significantly lower in AirSeal® LP group at hour 4, 8 and 24. Maximal values of ETCO2, systolic blood pressure, and peak airway pressure were significantly lower in AirSeal®-LP group. CONCLUSION: LP (7mmHg) laparoscopy with AirSeal® platform allows laparoscopic surgery with less postoperative shoulder pain. These results could facilitate the development of ambulatory laparoscopy.


Assuntos
Procedimentos Cirúrgicos em Ginecologia , Insuflação , Laparoscopia , Pneumoperitônio Artificial/métodos , Pneumoperitônio Artificial/normas , Adulto , Estudos de Viabilidade , Feminino , Procedimentos Cirúrgicos em Ginecologia/efeitos adversos , Procedimentos Cirúrgicos em Ginecologia/métodos , Procedimentos Cirúrgicos em Ginecologia/normas , Humanos , Insuflação/efeitos adversos , Insuflação/métodos , Insuflação/normas , Laparoscopia/efeitos adversos , Laparoscopia/métodos , Laparoscopia/normas , Pessoa de Meia-Idade , Medição da Dor , Dor Pós-Operatória/etiologia , Projetos Piloto , Pneumoperitônio Artificial/efeitos adversos , Pressão , Dor de Ombro/etiologia , Padrão de Cuidado , Adulto Jovem
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