The effects of trendelenburg and reverse trendelenburg position on hemodynamics, oxidative stress factors, postoperative shoulder and back pain in elective laparoscopic surgery

Laparoscopy; view and make surgical operation without opening the abdomen. The allure of laparoscopic interventions are technology improvements,less postoperative pain, short duration of hospital stay and return to normal daily activity quickly. We had different positions in laparoscopic cases, because of looking operation area more comfortable, removal of organs to opportunity for surgical case. In our study, we aimed to examine the impact on patients who had an operation on these positions. In this study, cases of upper and lower elective laparoscopic abdominal trendelenburg and reverse trendelenburg position hemodynamics, TAS and TOS values, the effects of postoperative pain in the shoulders and back views. After Ethics Committee approval and informed consent in writing of the patients, we began the study ages 18-65, ASA I and II, which was attended by 60 female cases. The patients were divided into two groups according to their position during operation. Ther wasn't any statistically difference between patient groups in terms of age, height and weight. There was no significant difference in terms of long positions (p>0.05). The duration of anesthesia and surgical in groups, these values in Group II were significantly higher (p<0,05). When looking at the ASA score of the patients in groups, ASA I is the majority of Group I and ASA II is the majority of Group II. We had blood samples from the patients both of groups, before operation position and end of the position during surgery, for searching TAS, TOS and blood gas parameters. We saw that; there were no statistically difference between TAS I, TOS I and TAS II (p>0.05). But TOS II values are increase in Group I and II. This also suggests that oxidative stress increased in both of groups. However, TOS II values are significantly higher in Group II (p<0,05). This is a comparison between groups values of TOS2 were significantly higher in Group II (p<0,05). This also show more oxidative stress increase in Group II. We compared OSİ 1 and OSİ 2 values in groups and between groups. Oxidative stress index (OSİ) computed by TAS and TOS results. TOS I and TAS I values, which are specified by using the OSİ 1 value. Groups showed no significant difference about OSİ 1 results (p>0.05). However TAS II and TOS II values, which are specified by using the OSİ2 values increased each groups. However, OSİ 2 results were significantly higher in Group II (p<0.05). That showed oxidative stress increased in both groups, but group II shows more increased. Blood gas parameters had some changes, both within the Group and between groups, although statistically significant differences were not seen (p>0.05). In this study, we researched the effects of postoperative shoulder and back pain according to patient position in surgery. We asked questions about postoperative shoulder and back pain postoperative 24.hours to patients in Group I and II. Group I patients were on trendelenburg position and Group II patients were on reverse trendelenburg position in surgery. Pain status was significantly higher in Group I patients according to Group II patients (p<0,05). VAS scores compared to the Group I and II. According to group I, VAS scores were significantly higher than Group II (p<0,05). Trendelenburg position caused more postoperative shoulder and back pain.