Comparison of Pain in the Kocher and Midline Incisions in Patients with Post Cholecystectomy
Abstract
Background: Incision techniques that are often used in cholecystectomy laparotomy are the Kocher incision and midline incision. This study was carried out to compare the pain in the Kocher's incision and midline incision in patients with postoperative cholecystectomy laparotomy.
Subjects and Method: : This study was an observational randomized controlled trial double sampling study conducted at the Department of Surgery Dr. Moewardi Hospital Surakarta in October 2018 to February 2019. The sample of this study was 30 patients aged 18-65 years old who were diagnosed with symptomatic cholelithiasis based on clinical, laboratory, and radiological tests. The samples were selected by simple random sampling. The dependent variable of this study was the pain. The independent variables were the Kocher and midline incision techniques. The pain was measured on a 24-hour postoperative VAS scale, range 1-10. Data were analyzed by t-test.
Results: There was no significant difference in pain level between the Kocher group (Mean= 2.33; SD=0.72) and the midline group (Mean= 2.20; SD=0.97) with p=0.192.
Conclusion: There is no difference in pain level due to the Kocher incision technique and the midline incision technique.
Keywords: pain, incision, kocher, midline, cholecystectomy
Correspondence: R. Th. Supraptomo. Anesthesia dan Intensive Therapy Department Dr. Moewardi Hospital, Surakarta. Jl. Kolonel Sutarto 132 Jebres, Surakarta, Central Java 57126. Email: ekasatrio@gmail.com. Mobile: 081229229567
Indonesian Journal of Medicine (2020), 05(03): 240-245
https://doi.org/10.26911/theijmed.2020.05.03.09
References
Apfelbaum J, Chen C, Mehta SS, Gan TJ (2003). Postoperative pain experience: Result from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 97(2): 534–540. https://doi.org/10.1213/01.ane.0000068822.10113.9e.
Burger JWA, van‘t Riet M, Jeekel J (2002). Abdominal incisions: Techniques and postoperative complications. Scand J Surg, 91: 315–321. Retrieved from: https://journals.sagepub.com/doi/pdf/10.1177/145749690209100401.
Goligher J, Graham NG, De Dombal FT, Giles GR, Clark CG (1969). The value of stretching of anal sphincters in the relief of pain after haemorrhoidectomy. Br J Surg, 56(5): 390. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/5781088.
Keshav K, Chahal MS, Joshi HS, Kashmir S, Agarwal R (2015). Prevalece of different types Gallstone in the patient with cholelithiasis at rohilkhan medical college and hospital. Int J Contemp Surg, 3(1): 1–4. http://doi.org/10.5958/2321-1024.2015-.00001.X.
Kloeters O, Ulrich DJO, Bloemsma G, van Houdt CIA (2016). Comparison of three different incision techniques in A1 pulley release on scar tissue formation and postoperative rehabilitation. Arch Orthop Trauma Surg. 136: 731–737. https://doi.org/10.1007/s00402-016-2430-z.
Leppert W (2009). Tramadol as an analgesic for mild to moderate cancer pain. Pharmacol Rep, 61(6): 978–992. https://doi.org/10.1016/s1734-1140(09)70159-8.
Parmar A, Parmar AD, Sheffield KM, Adhikari D, Davee RA, Vargas GM, Tamirisa NP, Kuo YF, et al. (2015). PREOPGallstones: A prognostic nomogram for the management of symptomatic cholelithiasis in older patients. Ann Surg, 261(6): 1184–1190. https://doi.org/10.1097/SLA.0000000000000868.
Patnaik VV, Singla RK, Bansal V (2001). Surgical incisions—Their anatomical basis part IV abdomen. J Anat. Soc. India, 50(2): 170–178. Retrieved from: http:-//medind.nic.in/jae/t01/i2/jaet01i2p170.pdf.
Taylor P (2007) Principle of Pain: Principle of Medical Pharmacology. 7th edn. Canada: Elsevier.