Pulmonary Recruitment Maneuver Effects on Laparoscopic Complications: An Evidence Based Practice Analysis

Abstract

<p >Postoperative shoulder pain is a common complication following laparoscopic surgery with an incidence as high as 80%.<span style="font-family: TimesNewRomanPSMT; font-size: xx-small;">1</span> The etiology of the shoulder pain is thought to be due to residual carbon dioxide in the abdominal cavity, however the exact mechanism has not been fully elucidated.</span><span style="font-family: TimesNewRomanPSMT; font-size: xx-small;"><span style="font-family: TimesNewRomanPSMT; font-size: xx-small;">2 </span></span><span style="font-family: TimesNewRomanPSMT;">Anesthesia providers are challenged with providing effective postoperative pain </span>relief while minimizing complications. Evidence in the literature suggests laparoscopic related complications such as pain and postoperative nausea and vomiting (PONV) can be reduced by implementing a pulmonary recruitment maneuver in Trendelenburg position (30°) at the end of surgery.<span style="font-family: TimesNewRomanPSMT; font-size: xx-small;">3 </span> The maneuver may also have an affect on postoperative analgesic requirements.</span><span style="font-family: TimesNewRomanPSMT; font-size: xx-small;">4,5 </span>The purpose of this evidence-based-analysis is to investigate the effects of a pulmonary recruitment maneuver at the end of laparoscopic surgery on postoperative pain, analgesic requirements, and PONV.</p>