Pain, Postoperative
Conditions
Keywords
Pain, Postoperative, Neuromuscular Blocking Agents, Laparoscopy
Brief summary
The purpose of this study was to investigate whether there is any difference in incidence of shoulder tip pain after laparoscopic cholecystectomy between the groups with moderate neuromuscular block and deep neuromuscular block.
Detailed description
Laparoscopic cholecystectomy has become the gold standard treatment for gall bladder disease. However, 30-50% of patients suffer from shoulder tip pain, which might arise from diaphragm stretch due to pneumoperitoneum. In the previous pilot study, working intra-abdominal space was increased in the condition of deep neuromuscular blockade. And thus investigators hypothesized that the depth of neuromuscular blockade can affect insufflation pressure and intra-abdominal volume, which result in the severity of diaphragm stretch and postoperative shoulder pain. In addition, the depth of neuromuscular blockade can alter pulmonary compliance.
Interventions
DRUGRocuronium
We will administrate neuromuscular blocking agent until moderate or deep neuromuscular blockade stabilized.
Sponsors
Yonsei University
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
PREVENTION
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
20 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* physical status by American society of Anesthesiology; 1 or 2 patients * patients with benign gallbladder disease scheduled for laparoscopic cholecystectomy
Exclusion criteria
* patient with myasthenia gravis * allergy to rocuronium or sugammadex * patient with shoulder pain disease (Ex. rotator cuff tear) * psychological disease * patients who cannot understand Korean
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Shoulder tip pain | upto postoperative 24 hours | The severity of shoulder tip pain will be measured in PACU and upto postoperative 6, 6-12, 12-24 hours. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Postoperative nausea and vomiting | upto postoperative 24hours | The severity of nausea, the number of vomiting and the dose and number of administration of rescue antiemetics will be recorded. |
| Intraoperative hemodynamics | upto postoperative 24hours | Heart rate and blood pressure will be measured at the completion of anesthetic induction, at the completion of carbon dioxide insufflation, at 15 minutes after carbon dioxide insufflation, at the completion of desufflation of pneumoperitoneum, and at the completion of operation. |
| Postoperative pain | upto postoperative 24 hours | The severity and the location of postoperative pain will be measured in PACU and upto postoperative 6, 6-12, 12-24 hours after operation. |
| Satisfaction of the surgeon | upto postoperative 24 hours | Satisfaction of the surgeon will be measured by 5-scale numeric rating scale) at the completion of surgery. |
| Working intrabdominal space | upto postoperative 24 hours | Working intrabdominal space will be measured by grasper (from skin to sacral promontory) at the completion of carbon dioxide insufflation. |
| pulmonary compliance | upto postoperative 24 hours | Total lung compliance will be measured by the equation : CT (L/cm H2O) = change in volume/ change in pleural pressure It will be measured at the completion of anesthetic induction, at the completion of carbon dioxide insufflation, at 15 minutes after carbon dioxide insufflation, at the completion of desufflation of pneumoperitoneum, and at the completion of operation |
Countries
South Korea
Outcome results
None listed