The influence of the pulmonary recruitment maneuver on post-laparoscopic shoulder pain in patients having a laparoscopic cholecystectomy: a randomized controlled trial

Background: Post-laparoscopic shoulder pain is very common after laparoscopy. One method to reduce postoperative shoulder pain is the pulmonary recruitment maneuver. It is used to reduce post-laparoscopic shoulder pain. This study utilizes a truly experimental, double-blinded, prospective randomized design to assess the effect of pulmonary recruitment maneuvers on post-laparoscopic shoulder pain after laparoscopic cholecystectomy. Methods: Sixty patients were allocated randomly into two groups. The intervention group received five manual pulmonary inflations for 5 s at a maximum pressure of 25 cm H₂O. The control group included patients whose residual CO₂ gas was evacuated from the abdominal cavity using passive exsufflation as the routine method at the end of surgery by abdominal massage. Gentle abdominal pressure was applied to facilitate CO₂ gas removal. Results: When Ramsay's Sedation Score’s results were compared between the two groups after the operation, there was no statistically significant difference between the two groups during the first and (p value = 0.20) second (p value = 0.61) hours. A repeated measures ANOVA revealed that the pulmonary recruitment maneuver is significant (p-value 0.001) and had a high effect size (0.527) in reducing shoulder pain among laparoscopic cholecystectomy patients after controlling the effect of other covariate patient characteristics. Conclusion: Utilizing a pulmonary recruitment maneuver at the end of laparoscopic surgery reduces shoulder pain.