Comparison of the efficiency of different techniques used in the prevention of pain after laparoscopic sleeve gastrectomy surgery

Aim: The main purpose of this study is to investigate the effect of different methods that may affect pain after laparoscopic sleeve gastrectomy surgery. Methods: Patients who were treated for morbid obesity in our clinic between January 2016 and January 2020 were analyzed retrospectively. The 90 patients who participated in the study were divided into three groups: Group 1: The active aspiration group; Group 2: The pulmonary recruitment maneuver (PRM) group; and Group 3: The intraperitoneal normal saline infusion (INSI) group. After completion of the operative procedures; residual gas was aspirated in Group 1. In the Group 2; the patients were placed in the Trendelenburg position (30°); and a pulmonary recruitment maneuver consisting of 5 manual pulmonary inflations was performed with a maximum pressure of 40 cm H2O. In the Group 3; the upper part of the abdominal cavity was even and bilaterally filled with isotonic normal saline (1000 mL); which was then left in the abdominal cavity. The patients (in all groups) were then placed in the level position; the trocar was removed; and the abdominal incisions were closed. Results: There was no statistical difference between the groups in terms of the duration of surgery; duration of hospital stay; and return to normal activity. Although pain levels were found to be high in all groups within 4 hours; no statistical differences were observed. Despite this; the pain levels at 24 hours; 48 hours; and 3 days showed no difference between Groups 1 and 2; while Group 3 was lower. The amount and frequency of analgesics used are less in Group 3. This situation is statistically significant. Conclusion: The INSI maneuver seemed to be much more effective in reducing upper abdominal and shoulder pain caused by laparoscopy; and the effect lasted longer.