Impact of low-pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients: A prospective randomised controlled study
Introduction: The impact of laparoscopic surgery on homeostatic systems necessitates careful consideration of intra-abdominal pressure (IAP) management. This study investigated the effects of low-pressure pneumoperitoneum with deep neuromuscular blockade (NMB) on surgeon satisfaction, haemodynamics...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2025-04-01
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| Series: | Journal of Minimal Access Surgery |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/jmas.jmas_78_24 |
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| author | Alparslan Koç Ufuk Memiş Didem Onk Talha Karataş Mustafa Gazi Ali Caner Sayar Muhammet Ali Arı |
| author_facet | Alparslan Koç Ufuk Memiş Didem Onk Talha Karataş Mustafa Gazi Ali Caner Sayar Muhammet Ali Arı |
| author_sort | Alparslan Koç |
| collection | DOAJ |
| description | Introduction:
The impact of laparoscopic surgery on homeostatic systems necessitates careful consideration of intra-abdominal pressure (IAP) management. This study investigated the effects of low-pressure pneumoperitoneum with deep neuromuscular blockade (NMB) on surgeon satisfaction, haemodynamics and post-operative outcomes in laparoscopic cholecystectomy patients.
Patients and Methods:
The study design involves prospective randomised control. Ninety patients were assigned to low (7–10 mmHg, n = 45) or normal (12–16 mmHg, n = 45) IAP groups. Deep NMB, guided by train-of-four monitoring, was administered. This study evaluated surgical rating scale scores, haemodynamics and post-operative outcomes through a literature review. A computer programme (IBM, SPSS) was used for statistical analysis. Chi-square and Mann-Whitney U tests were used to analyse patients’ IAP levels, additional NMB requirements, surgical rating scale scores and numerical rating scales. Patient demographics and other intraoperative and post-operative variables were analysed with Student’s t-test and the Mann-Whitney U test. Values of P < 0.05 were considered to indicate statistical significance.
Results:
No significant demographic differences were observed. The low-pressure group exhibited lower post-operative pain (P < 0.01) and reduced analgesia requirements (P = 0.00). On analysis of the surgeon rating scale, no disparities were evident between the groups. NMB usage correlated with height and weight (P < 0.01). Heart rate showed no intergroup differences. The MAP measured after 15 min was lower in Group L, and the difference was significant (P = 0.023). The SAP measured after 30 min was lower in Group L, and the difference was significant (P = 0.017). Blood gas values and surgical field visibility were unaffected by the IAP. The positive correlations between NMB, height and weight aligned with previous research.
Conclusion:
This study highlights successful laparoscopic cholecystectomy under low IAP, deep NMB and favourable post-operative outcomes. Despite these limitations, the findings contribute to optimising laparoscopic surgical approaches. |
| format | Article |
| id | doaj-art-9c625096197f4b9e93dfdf06e6cd37f0 |
| institution | Kabale University |
| issn | 0972-9941 1998-3921 |
| language | English |
| publishDate | 2025-04-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Minimal Access Surgery |
| spelling | doaj-art-9c625096197f4b9e93dfdf06e6cd37f02025-08-20T03:53:06ZengWolters Kluwer Medknow PublicationsJournal of Minimal Access Surgery0972-99411998-39212025-04-0121218318810.4103/jmas.jmas_78_24Impact of low-pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients: A prospective randomised controlled studyAlparslan KoçUfuk MemişDidem OnkTalha KarataşMustafa GaziAli Caner SayarMuhammet Ali ArıIntroduction: The impact of laparoscopic surgery on homeostatic systems necessitates careful consideration of intra-abdominal pressure (IAP) management. This study investigated the effects of low-pressure pneumoperitoneum with deep neuromuscular blockade (NMB) on surgeon satisfaction, haemodynamics and post-operative outcomes in laparoscopic cholecystectomy patients. Patients and Methods: The study design involves prospective randomised control. Ninety patients were assigned to low (7–10 mmHg, n = 45) or normal (12–16 mmHg, n = 45) IAP groups. Deep NMB, guided by train-of-four monitoring, was administered. This study evaluated surgical rating scale scores, haemodynamics and post-operative outcomes through a literature review. A computer programme (IBM, SPSS) was used for statistical analysis. Chi-square and Mann-Whitney U tests were used to analyse patients’ IAP levels, additional NMB requirements, surgical rating scale scores and numerical rating scales. Patient demographics and other intraoperative and post-operative variables were analysed with Student’s t-test and the Mann-Whitney U test. Values of P < 0.05 were considered to indicate statistical significance. Results: No significant demographic differences were observed. The low-pressure group exhibited lower post-operative pain (P < 0.01) and reduced analgesia requirements (P = 0.00). On analysis of the surgeon rating scale, no disparities were evident between the groups. NMB usage correlated with height and weight (P < 0.01). Heart rate showed no intergroup differences. The MAP measured after 15 min was lower in Group L, and the difference was significant (P = 0.023). The SAP measured after 30 min was lower in Group L, and the difference was significant (P = 0.017). Blood gas values and surgical field visibility were unaffected by the IAP. The positive correlations between NMB, height and weight aligned with previous research. Conclusion: This study highlights successful laparoscopic cholecystectomy under low IAP, deep NMB and favourable post-operative outcomes. Despite these limitations, the findings contribute to optimising laparoscopic surgical approaches.https://journals.lww.com/10.4103/jmas.jmas_78_24deep neuromuscular blockadelaparoscopic surgerylow-pressure pneumoperitoneumpost-operative outcomessurgical satisfaction |
| spellingShingle | Alparslan Koç Ufuk Memiş Didem Onk Talha Karataş Mustafa Gazi Ali Caner Sayar Muhammet Ali Arı Impact of low-pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients: A prospective randomised controlled study Journal of Minimal Access Surgery deep neuromuscular blockade laparoscopic surgery low-pressure pneumoperitoneum post-operative outcomes surgical satisfaction |
| title | Impact of low-pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients: A prospective randomised controlled study |
| title_full | Impact of low-pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients: A prospective randomised controlled study |
| title_fullStr | Impact of low-pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients: A prospective randomised controlled study |
| title_full_unstemmed | Impact of low-pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients: A prospective randomised controlled study |
| title_short | Impact of low-pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients: A prospective randomised controlled study |
| title_sort | impact of low pressure pneumoperitoneum and deep neuromuscular blockade on surgeon satisfaction and patient outcomes in laparoscopic cholecystectomy patients a prospective randomised controlled study |
| topic | deep neuromuscular blockade laparoscopic surgery low-pressure pneumoperitoneum post-operative outcomes surgical satisfaction |
| url | https://journals.lww.com/10.4103/jmas.jmas_78_24 |
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