Non-pharmacological pain relief after laparoscopic cholecystectomy: the role of pulmonary recruitment maneuver

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BACKGROUND

Laparoscopic cholecystectomy is extensively acknowledged as one of the most prevalent surgical interventions in the domain of general surgery globally, with its occurrence being particularly pronounced in numerous Arab nations where the frequency of this procedure is markedly elevated.

OBJECTIVE

To evaluate the efficacy of pulmonary recruitment maneuver (PRM) as a non-pharmacological method for reducing postoperative pain, especially shoulder pain, after laparoscopic cholecystectomy.

MATERIAL AND METHODS

The study was A Randomized Controlled Trial study, conducted in Dhi Qar Governorate at Al-Hussein Teaching Hospital, Digestive System and Liver Center, as well as at Al-Nasiriyah Teaching Hospital, from November 2024 to February 15, 2025. A probability random sample that comprises 132 all of whom underwent the surgical procedure was divided randomly into two groups 66 patients for the study group and 66 patients for the control group. The study instrument consisted of two parts (1) demographic data and clinical information (2) Visual Analogue Scale (VAS) accurately measures the outcomes.

RESULTS

PRM significantly reduced shoulder pain severity and analgesic requirements compared to the control group. Patients who underwent PRM also tended to have shorter hospital stays and better postoperative comfort.

CONCLUSION

PRM is a simple, safe, effective, and non-pharmacological technique for relieving shoulder pain after laparoscopic cholecystectomy. It can be recommended as a routine part of postoperative care to improve pain management and patient satisfaction.

Keywords:

pulmonary recruitment maneuver

shoulder pain

laparoscopic cholecystectomy

Authors:

Hussein Mahmoud

Ministry of Health — The Qar Health Directorate, Dhi Qar, Iraq

Majid Ayad

University of Baghdad, Baghdad, Iraq

Received:

03.05.2025

Accepted:

14.10.2025

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