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Background <p>Residual carbon dioxide (CO₂) after laparoscopic cholecystectomy (LC) may contribute to early postoperative pain. Active aspiration of CO₂ has been proposed as a simple adjunct, but large cohort data remain limited.</p> Methods <p>This non-randomized prospective cohort study included 270 patients undergoing LC between May 2025 and October 2025. Patients were allocated to either the active aspiration group (<i>n</i> = 135) or the passive evacuation group (<i>n</i> = 135). Pain was evaluated using the Visual Analog Scale (VAS) at 4 and 24&#xa0;h. Statistical analyses included chi-square tests, independent and paired t-tests, and Pearson correlation. A priori power analysis determined that 266 patients (133 per group) were required (effect size d = 0.40, α = 0.05, power = 0.90).</p> Results <p>The aspiration group had significantly lower pain scores at both 4&#xa0;h (3.48 ± 1.08 vs. 5.30 ± 1.60; <i>p</i> &lt; 0.001) and 24&#xa0;h (1.69 ± 0.94 vs. 3.59 ± 1.38; <i>p</i> &lt; 0.001). Active aspiration was associated with lower pain scores at both time points (<i>p</i> &lt; 0.001).</p> Conclusion <p>Active evacuation of residual CO₂ was associated with lower postoperative pain scores following LC. Given the non-randomized design, causal inference is limited, and the findings should be interpreted cautiously.</p>

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Relieving the pressure: the effect of active carbon dioxide aspiration on postoperative pain after laparoscopic cholecystectomy

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月4日

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  • Osman Gökhan Gökdere,
  • Bahadır Öndeş,
  • Ahmet Aydın

摘要

Background

Residual carbon dioxide (CO₂) after laparoscopic cholecystectomy (LC) may contribute to early postoperative pain. Active aspiration of CO₂ has been proposed as a simple adjunct, but large cohort data remain limited.

Methods

This non-randomized prospective cohort study included 270 patients undergoing LC between May 2025 and October 2025. Patients were allocated to either the active aspiration group (n = 135) or the passive evacuation group (n = 135). Pain was evaluated using the Visual Analog Scale (VAS) at 4 and 24 h. Statistical analyses included chi-square tests, independent and paired t-tests, and Pearson correlation. A priori power analysis determined that 266 patients (133 per group) were required (effect size d = 0.40, α = 0.05, power = 0.90).

Results

The aspiration group had significantly lower pain scores at both 4 h (3.48 ± 1.08 vs. 5.30 ± 1.60; p < 0.001) and 24 h (1.69 ± 0.94 vs. 3.59 ± 1.38; p < 0.001). Active aspiration was associated with lower pain scores at both time points (p < 0.001).

Conclusion

Active evacuation of residual CO₂ was associated with lower postoperative pain scores following LC. Given the non-randomized design, causal inference is limited, and the findings should be interpreted cautiously.