Effect of Intra-Abdominal Pressure on Post-Operative Discharge Criteria in Laparascopic Cholecystectomy

Abstract

Background: Pneumoperitoneum results in respiratory and hemodynamic changes. It is unknown whether hemodynamic changes that last to the recovery room could change recovery criteria.To determine the effect of decrease in intra-abdominal pressure on discharge criteria after laparascopic cholecystectomy.
Methods: Patients with age 25-65 who were candidated for elective laparascopy cholecystectomy were enrolled in the study. In high pressure group, intra-abdominal pressure was maintained at 12, and in low pressure group at 8 mmHg. Intra-abdominal insufflation was performed using CO2. After surgery, patients were transferred to recovery room. Heart rate, blood pressure, and pulse oxymetery monitoring were continued in recovery room and modified Aldrete scores were measured every 4 minutes. Patients were discharged from recovery if they had Aldrete score> 9.
Results: Aldrete scores were lower in high pressure group compared to low pressure group at 4 and 8 minutes in recovery room, however this difference was not significant (p=0.17, 0.44; respectively). At 12, 16, 20 and 24 minutes Aldrete scores were not significantly different between two groups (p> 0.05).
Conclusion: The effect of decreasing intraabdominal pressure from 12 to 8 mmHg during insufflations of CO2 in laparascopy induces only minor non-significant decrease in discharge time and criteria.