{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,20]],"date-time":"2026-05-20T00:28:40Z","timestamp":1779236920057,"version":"3.51.4"},"reference-count":28,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2006,10,6]],"date-time":"2006-10-06T00:00:00Z","timestamp":1160092800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2006,11]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Intraabdominal CO<jats:sub>2<\/jats:sub> gas after laparoscopic cholecystectomy causes postoperative shoulder\u2010tip pain. Many methods of analgesia have been used to reduce this pain, including analgesic drugs, intraperitoneal local anesthetic, intraperitoneal saline, a gas drain, heated gas, low\u2010pressure gas, and nitrous oxide pneumoperitoneum. The aim of this study was to evaluate the efficacy of combined low\u2010pressure CO<jats:sub>2<\/jats:sub> pneumoperitoneum and intraperitoneal infusion of normal saline in reducing the incidence of postoperative shoulder\u2010tip pain.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Altogether, 109 patients undergoing elective laparoscopic cholecystectomy were randomized prospectively into three groups. Patients in group A (<jats:italic>n<\/jats:italic> = 34) underwent laparoscopic cholecystectomy with 14\u00a0mmHg CO<jats:sub>2<\/jats:sub> pneumoperitoneum; patients in group B (<jats:italic>n<\/jats:italic> = 37) underwent laparoscopic cholecystectomy with 10\u00a0mmHg CO<jats:sub>2<\/jats:sub> pneumoperitoneum; and those in group C (<jats:italic>n<\/jats:italic> = 38) underwent laparoscopic cholecystectomy with 10\u00a0mmHg CO<jats:sub>2<\/jats:sub> pneumoperitoneum in addition to intraperitoneal normal saline infusion in the right hemidiaphragmatic area. Shoulder\u2010tip pain was recorded on a verbal rating scale 2, 6, 12, 24, and 48 hours after operation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Twelve patients in group A (35.2 percent), six in group B (16.2 percent), and seven in group C (18.4 percent) complained of shoulder\u2010tip pain. Hence, there was a significant decrease in the frequency of shoulder\u2010tip pain in groups B and C in relation to group A, but there was no significant difference between groups B and C. The postoperative shoulder\u2010tip pain scores were significantly reduced in group C at 6, 12, and 24 hours. The number of patients who required additional analgesics was also reduced in group C.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Low\u2010pressure CO<jats:sub>2<\/jats:sub> pneumoperitoneum reduces the number of patients complaining of shoulder\u2010tip pain and the intensity of the pain after laparoscopic cholecystectomy. The addition of intraperitoneal normal saline infusion to low\u2010pressure CO<jats:sub>2<\/jats:sub> pneumoperitoneum seems to reduce the intensity but not the frequency of shoulder\u2010tip pain after laparoscopic cholecystectomy.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-005-0752-z","type":"journal-article","created":{"date-parts":[[2006,10,17]],"date-time":"2006-10-17T07:31:25Z","timestamp":1161070285000},"page":"1969-1973","source":"Crossref","is-referenced-by-count":57,"title":["Combined Low Pressure Pneumoperitoneum and Intraperitoneal Infusion of Normal Saline for Reducing Shoulder Tip Pain Following Laparoscopic Cholecystectomy"],"prefix":"10.1002","volume":"30","author":[{"given":"M. Emad","family":"Esmat","sequence":"first","affiliation":[{"name":"Department of Surgery Theodor Bilharz Research Institute Kornish el Nile, Warak, Imbaba, PO Box 30 12411 Giza Cairo Egypt"},{"name":"31 Cedarhurst B32 2JZ Harborne Birmingham UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magdy M.A.","family":"Elsebae","sequence":"additional","affiliation":[{"name":"Department of Surgery Theodor Bilharz Research Institute Kornish el Nile, Warak, Imbaba, PO Box 30 12411 Giza Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Magid M.A.","family":"Nasr","sequence":"additional","affiliation":[{"name":"Department of Surgery Theodor Bilharz Research Institute Kornish el Nile, Warak, Imbaba, PO Box 30 12411 Giza Cairo Egypt"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sameh B.","family":"Elsebaie","sequence":"additional","affiliation":[{"name":"Department of Surgery Theodor Bilharz Research Institute Kornish el Nile, Warak, 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