Evaluation of Pulmonary Recruitment Manoeuver in Laparoscopy to decrease postoperative pain.

Laparoscopic surgery has gained signiï¬cant ground in the operative field as a minimally invasive technique it offers the advantages of decrease in the interval until return to daily activity. This is mainly accomplished through reduction of postoperative pain. However, signiï¬cant proportion of patients still require postoperative analgesia, because these patients seem to suffer from shoulder and/or abdominal pain. The intensity of this type of pain may range from subtle to severe and rarely persists for a period longer than 72 h. Numerous pathophysiologic pathways have been proposed, with carbon dioxide residual and phrenic nerve damage during diaphragmatic stretching being the most accepted theories. While several number of studies have investigated in the past various techniques that could potentially alleviate this type of pain. Over years, several studies have proposed that a simple anesthesiologic maneuver involving pulmonary recruitment after the completion of the laparoscopic procedure might improve the postoperative pain scores of those patients. The pulmonary recruitment maneuver, involves a series of positive pressure ventilations after the completion of the laparoscopic procedure. It increases the intra-abdominal pressure, and consequently reduces the residual gas in the abdominal cavity.