{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:57:28Z","timestamp":1791568648260,"version":"4.3.4"},"reference-count":14,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T00:00:00Z","timestamp":1791504000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Low-pressure pneumoperitoneum (LPP) has been proposed to improve postoperative pain in laparoscopic surgery. This randomized controlled trial (RCT) aimed to evaluate the impact of LPP versus standard-pressure pneumoperitoneum (SPP) on postoperative pain and surgical outcomes during laparoscopic cholecystectomy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A randomized, controlled, double-blind trial was performed between November 12, 2024 and December 31, 2025. Patients scheduled for elective laparoscopic cholecystectomy (LC) were randomized into two groups: LPP group (8 mmHg) versus SPP group (14 mmHg). The primary outcome was postoperative pain assessed by the Visual Analogue Scale (VAS) at 6 hours. Secondary outcomes included operative time, analgesic consumption, postoperative nausea and vomiting (PONV), and surgical complications. Data were analyzed using an intention-to-treat approach. This trial has been registered at ClinicalTrials.gov (\n                      <jats:bold>NCT06685250<\/jats:bold>\n                      ) on November 11, 2024.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>One hundred sixty consecutive patients were enrolled. There was no statistically significant difference in median VAS pain scores at 6 hours (3 vs. 4; p\u2009=\u20090.221), 12 hours (2 vs. 3; p\u2009=\u20090.074), or 24 hours (1 vs. 2; p\u2009=\u20090.128) postoperatively. However, the mean consumption of paracetamol during the first 24 hours was significantly lower in the LPP group compared to the SPP group (1.04\u2009\u00b1\u20090.906 vs. 1.35\u2009\u00b1\u20090.873; p\u2009=\u20090.014). Operative times were similar (59.9\u2009\u00b1\u200927.5 vs. 58.2\u2009\u00b1\u200922.4 minutes; p\u2009=\u20090.880). No conversion to laparotomy or major morbidities were recorded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>LPP (8 mmHg) was feasible without increasing operative duration. It did not show a statistically significant reduction in VAS pain scores at 6 hours. Larger studies are required to confirm safety equivalence regarding rare surgical complications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pone.0360476","type":"journal-article","created":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T17:39:09Z","timestamp":1791567549000},"page":"e0360476","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Low pressure (8 mmHg) pneumoperitoneum does not significantly reduce postoperative visual analog scale score after laparoscopic cholecystectomy: Randomized trial"],"prefix":"10.1371","volume":"21","author":[{"given":"Amine Ben","family":"Safta","sequence":"first","affiliation":[{"name":"Charles Nicolle University Hospital","place":["Tunis, Tunisia"],"department":["Department of Digestive Surgery B"]},{"name":"University of Tunis El Manar","place":["Tunisia"],"department":["Faculty of Medicine of 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Tunisia"],"department":["Department of Digestive Surgery B"]},{"name":"University of Tunis El Manar","place":["Tunisia"],"department":["Faculty of Medicine of Tunis"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-7677-1468","authenticated-orcid":true,"given":"Raja","family":"Bousassi","sequence":"additional","affiliation":[{"name":"University of Tunis El Manar","place":["Tunisia"],"department":["Faculty of Medicine of Tunis"]},{"name":"Charles Nicolle University Hospital","place":["Tunis, Tunisia"],"department":["Department of Anesthesiology"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hajer","family":"Taher","sequence":"additional","affiliation":[{"name":"Charles Nicolle University Hospital","place":["Tunis, Tunisia"],"department":["Department of Digestive Surgery B"]},{"name":"University of Tunis El Manar","place":["Tunisia"],"department":["Faculty of Medicine of 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