Effects of Intra-abdominally Instilled Isotonic Saline on Pain, Recovery, and Health-Related Quality-of-Life Following Laparoscopic Cholecystectomy: A Randomized Prospective Double-Blind Controlled Study

World J Surg. 2015 Jun;39(6):1413-20. doi: 10.1007/s00268-015-2978-8.

Abstract

Introduction: The postoperative installation of isotonic saline in the abdomen has been suggested as a method to reduce the effect of local toxins, thereby reducing postoperative pain in patients undergoing laparoscopic surgery. The aim of this randomized prospective double-blind trial was to assess whether installation of isotonic saline can reduce postoperative pain and nausea following laparoscopic cholecystectomy (LC).

Methods: Altogether 71 LC patients were randomized to either intra-abdominal instillation of isotonic saline group (S) (n = 36) or no saline (NS) group (n = 35) at the end of surgery. Data were collected by means of questionnaires. The postoperative recovery profile questionnaire was answered prior to surgery and 1 week postoperatively, SF-36 prior to surgery and at 1 month postoperatively, and a pain diary recording a Visual Analogue Scale score each day during the first week.

Results: The overall response rate was 94%. No significant differences were seen between the groups regarding abdominal and shoulder pain. However, the NS group reported more pain (NS = 53 %, S = 29 %) and fatigue (NS = 50%, S = 35%) than the S group postoperative day 7. Moreover, the most frequently reported problem in both groups 7 days after surgery was getting back to normal life (60%). Females reported a slower recovery profile than males and also more postoperative symptoms day 7. HRQoL results were similar between the groups.

Conclusion: Instillation of isotonic saline does not improve recovery after laparoscopic cholecystectomy. Postoperative pain was more often reported in the NS group than in the S group, though the difference was not significant.

Publication types

  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abdomen
  • Abdominal Pain / etiology
  • Abdominal Pain / prevention & control
  • Adult
  • Aged
  • Cholecystectomy, Laparoscopic / adverse effects*
  • Double-Blind Method
  • Female
  • Humans
  • Instillation, Drug
  • Isotonic Solutions / administration & dosage
  • Male
  • Middle Aged
  • Nausea / etiology
  • Nausea / prevention & control
  • Pain, Postoperative / etiology
  • Pain, Postoperative / prevention & control*
  • Prospective Studies
  • Quality of Life
  • Sex Factors
  • Shoulder Pain / etiology
  • Shoulder Pain / prevention & control
  • Sodium Chloride / administration & dosage*
  • Time Factors

Substances

  • Isotonic Solutions
  • Sodium Chloride