{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T05:32:18Z","timestamp":1790141538773,"version":"4.0.1"},"reference-count":21,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The use of low\u2010pressure pneumoperitoneum seems to be capable of reducing complications such as post\u2010operative pain. However, the quality of evidence supporting this conclusion is low. Both the lack of investigator blinding to both intra\u2010abdominal pressure and to method of neuromuscular blockade represent key sources of bias. Hence, this prospective, randomised, and double\u2010blind study aimed to compare the quality of recovery (Questionnaire QoR\u201040) of patients undergoing laparoscopic cholecystectomy under low\u2010pressure and standard\u2010pressure pneumoperitoneum. We tested the hypothesis that low pneumoperitoneum pressure enhances the quality of recovery following LC.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Eighty patients who underwent elective laparoscopic cholecystectomy were randomly divided into two groups, a low\u2010pressure (10\u00a0mm Hg) pneumoperitoneum group and a standard\u2010pressure (14\u00a0mm Hg) pneumoperitoneum group. For all participants, the value of the insufflation pressure was kept hidden and only the nurse responsible for the operating room was aware of it. Deep neuromuscular blockade was induced for all cases [train\u2010of\u2010four (TOF) = 0; post\u2010tetanic count (PTC) &gt; 0]. The quality of recovery was assessed on the morning of first post\u2010operative day.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>No difference was found in either total score or in its different dimensions according to the QoR\u201040 questionnaire. The patients in the low\u2010pressure pneumoperitoneum group experienced more pain during forced coughing measured at 4\u00a0hours (median difference [95% CI], 1 [0\u20102]; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.030), 8\u00a0hours (1 [0\u20102]; <jats:italic>P<\/jats:italic>\u00a0=\u00a0.030) and 12\u00a0hours (0 [0\u20101] <jats:italic>P<\/jats:italic>\u00a0=\u00a0.025) after discharge from the post\u2010anaesthesia care unit, when compared with those in the standard\u2010pressure pneumoperitoneum group.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>We thus conclude that the use of low\u2010pressure pneumoperitoneum during elective laparoscopic cholecystectomy does not improve the quality of recovery.<\/jats:p><\/jats:sec>","DOI":"10.1111\/aas.13938","type":"journal-article","created":{"date-parts":[[2021,6,7]],"date-time":"2021-06-07T16:08:21Z","timestamp":1623082101000},"page":"1240-1247","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Quality of recovery in patients under low\u2010 or standard\u2010pressure pneumoperitoneum. A randomised controlled trial"],"prefix":"10.1111","volume":"65","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0145-4111","authenticated-orcid":false,"given":"Eduardo T.","family":"Moro","sequence":"first","affiliation":[{"name":"Department of Surgery School of Medical and Health Sciences Pontifical Catholic University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Persio C. C.","family":"Pinto","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medical and Health Sciences Pontifical Catholic University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ant\u00f4nio J. M. M.","family":"Neto","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medical and Health Sciences Pontifical Catholic University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto L.","family":"Hilkner","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medical and Health Sciences Pontifical Catholic University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luis F. P.","family":"Salvador","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medical and Health Sciences Pontifical Catholic University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beatriz R. D.","family":"da Silva","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medical and Health Sciences Pontifical Catholic University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isabella G.","family":"Souto","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medical and Health Sciences Pontifical Catholic University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata","family":"Boralli","sequence":"additional","affiliation":[{"name":"Department of Surgery School of Medical and Health Sciences Pontifical Catholic University of S\u00e3o Paulo S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joshua","family":"Bloomstone","sequence":"additional","affiliation":[{"name":"University of Arizona College of Medicine Phoenix AZ USA"},{"name":"Division of Surgery and Interventional Sciences University College London London England"},{"name":"Envision Physician Services Plantation FL USA"},{"name":"Outcomes Research Consortium Cleveland OH USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"e_1_2_4_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2017.05.071"},{"key":"e_1_2_4_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00464-015-4454-9"},{"issue":"3","key":"e_1_2_4_4_1","first-page":"CD006930","article-title":"Low pressure vs standard pressure pneumoperitoneum in laparoscopic cholecystectomy","volume":"18","author":"Gurusamy KS","year":"2014","journal-title":"Cochrane Database 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