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Abstract
Background : Shoulder pain after laparoscopy is common and its probable mechanism is residual CO2 gas after surgery . Intraperitoneal instillation of local anaesthetic and pulmonary recruitment manoeuvre are common methods of providing post- laparoscopy pain relief, but the combined effect of the two methods has not been reported.Objective We compared the efficacy of intraperitoneal instillation of Lidocaine, Pulmonary recruitment manoeuvre and combining both methods on postoperative pain following diagnostic gynaecologic laparoscopy.Methods This prospective, single-blinded, controlled study involved 48 female patients undergoing diagnostic gynaecologic laparoscopy. Patients were randomly divided into 4 equal groups, each of 12 patients. group GL received intraperitoneal 1.75{u2009}ml/kg of 0.2% Lidocaine splashed by the surgeon at the beginning of the procedure. group GP received pulmonary recruitment manoeuvre at the end of the procedure and consisting of five manual inflations to a maximum pressure of 40cmH₂O. group GPL received both methods. Control group GC Patients received passive exsufflation through the port site.The intensity of postoperative abdominal and shoulder pain was evaluated using a a visual analogue scale (VAS) at 1, 3, 6 hours postoperatively. The time of first analgesic requested and Vital signs also were recorded