Comparing the effect of the application of pulmonary recruitment maneuver and supplemental oxygen therapy and their combination on shoulder pain and nausea and vomiting in patients undergoing laparoscopic cholecystectomy in the Shahid Arefian Hospital of Urmia

The effect of pulmonary recruitment maneuver and supplemental oxygen therapy and their combination on shoulder pain, nausea, and vomiting in patients undergoing laparoscopic cholecystectomy

100 patients will be randomly divided into four groups A, B, C, D, with a ratio of 1:1:1:1. The main researcher (anesthesiologist) has been working for 10 years and has complete mastery of both of these methods; This technique will be performed under the supervision of an anesthesiologist and a surgeon.

In the operating room of Arefian Hospital in Urmia, shoulder pain will be assessed using VAS tools in 4, 12, and 24 hours after surgery in all groups. Rhodes-induced nausea and vomiting will be assessed in 12 and 24 hours after surgery.

Inclusion criteria: Patients with anesthesia class one and two in the age range of 35 to 55 years and no underlying diseases and nausea and vomiting, non-smoking / Exclusion conditions: Patients with intra-abdominal pressure more than 14 mm Hg, receiving anti-inflammatory drugs Vomiting, infectious infection of the peritoneal cavity, and adhesions, change of surgical procedure to laparotomy, underlying disease, smoking

combined method group (A), two interventions of pulmonary recruiting maneuvers with complementary oxygen therapy will be performed. In the pulmonary recruiting group (B), the ventilator airway pressure relief valve will close to fill the bag. Then five manual breaths will be given. For supplemental oxygen therapy group (C), the moment the patient enters the ward until 6 hours later, oxygen will be administered through the nasal cannula 4 lit/min. In the control group (D), the usual procedure will be performed by applying gentle abdominal pressure to remove CO2 through the port site at the end of surgery.

Shoulder pain and nausea and vomiting

In this study, random allocation with a ratio of 1: 1: 1: 1 will be divided into four groups: pulmonary record, complementary oxygen therapy, combined method (pulmonary record and complementary oxygen therapy), and control using the secure envelope method. In this way, inside the envelopes, closed sheets will contain all four approaches with equal proportions and sample volumes. Before starting the interventions, a person not related to the research will randomly select one of the sheets. Moreover, the patient will subsequently be assigned to that group. Due to the nature of the study, the patient will not know which group will be assigned. Also, when analyzing the data, the groups will be provided to the statistical analyst anonymously with the English letters A, B, C, and D; Therefore, the study will be double-blind.

The present study will be a double-blind, four-group, 2 * 2 factorial design clinical trial.