Abstract

Background: Standard pressure pneumoperitoneum in laparoscopic cholecystectomy with a pressure range of 12-14 mm Hg in comparison with the use of low pressure pneumoperitoneum in the range of 8-10 mm Hg in an attempt to lower the effect of pneumoperitoneum while maintaining adequate working space. Our study proposes to do this comparison by the use of deep muscle relaxation to improve the surgical conditions during laparoscopic surgery. Aim of the study: To study the effect of deep versus adequate muscle relaxation in laparoscopic cholecystectomy and the effect on intraperitoneal pressure and surgical satisfaction. Methods: 50 patients enrolled in the study for elective laparoscopic cholecystectomy .randomly divided in to two groups; group A: deep muscle relaxation and group B: adequate muscle relaxation using Rocuronium in both group and vital signs ,IPP ,TOF ,PTC recorded every 10 minutes, reversal was done by the use of sugammadex . Surgical satisfaction assessed at the end of surgery according to visual analogue scale. Results: There is non-significant difference in demographic data between the two groups. But there was a significant difference in IPP between the two groups in group A the IPP is less than in group B. also significant difference in surgical satisfaction observed between the two groups ,in group A surgical satisfaction significantly higher than group B. Conclusion: The deep neuromuscular blockade lowers the IPP significantly and improve surgical space in elective laparoscopic cholecystectomy