A study on the use of intraperitoneal normal saline to reduce shoulder pain post-laparoscopic Cholesystectomy

Background: Laparoscopic cholecystectomy is widely regarded as the treatment of choice for symptomatic cholelithiasis, offering several benefits over open surgery, such as reduced postoperative discomfort. Despite this, shoulder tip pain remains a common postoperative issue, impacting both recovery and patient satisfaction. This study seeks to assess the effectiveness of different analgesic interventions in reducing shoulder tip pain following laparoscopic cholecystectomy. Through the evaluation of patient outcomes and pain control methods, the goal is to determine the most effective strategies to support recovery and enhance patient comfort and satisfaction.
Material and Methods: This prospective comparative study involved 80 patients scheduled for elective laparoscopic cholecystectomy, who were randomly assigned into two groups: a control group (no irrigation) and an intervention group receiving intraperitoneal instillation of 1000 ml of normal saline warmed to 37°C. Postoperative pain was evaluated using the Visual Analog Scale (VAS) at 6, 18, and 24 hours. Additionally, the requirement for analgesics within the first 24 hours was documented for both groups.
Results: The normal saline group showed a significant reduction in shoulder tip pain at 6 hours (P=0.031) and 18 hours (P=0.029) postoperatively compared to the control group, with no notable difference at 24 hours (P=0.152). Mean pain intensity was also significantly lower at 6 hours (P=0.002) and 18 hours (P=0.037). Analgesic requirements were significantly less in the saline group during the first 6 hours (P=0.014), with no significant difference observed afterward.
Conclusion: Intraperitoneal instillation of normal saline significantly alleviates early postoperative shoulder pain following laparoscopic cholecystectomy. This technique is simple, safe, and may be effectively integrated into routine surgical protocols to improve patient recovery and comfort.