Perioperative Pulmonary Function in Laparoscopic Cholecystectomy Versus Open Cholecystectomy, with preemptive Intercostal Nerve Block

Background: The purpose of this study was to assess the efficacy of open cholecystectomy with right intercostal nerve block as an equivalent or substitute to laparoscopic cholecystectomy as regarding to the effect on the postoperative pulmonary function. Methods: Forty female patients included in the study, were allocated randomly into two groups (20 patients in each) group (I) undergone laparoscopic cholecystectomy, while group (II) was subjected for open cholecystectomy with preemptive right intercostal nerve block. VC, FVC, FEV1, PEFR, and ABG were assessed. Results: All measured parameters of pulmonary function were markedly depressed early postoperative with some improvements noticed 4 hours later but still far from the preoperative values. These reductions in pulmonary function were less marked in open cholecystectomy with intercostal nerve block (II) than in laparoscopic cholecystectomy (I). The operative time and total required dose of meperidine were significantly lower in group (II) than group (I). There were no changes in AGS between groups or within the same group. Conclusion: Open cholecystectomy with preemptive right intercostal nerve block can be less deterious or at least equivalent to laparoscopic cholecystectomy as regards the effect on postoperative pulmonary function and the total 24 hour requirement of meperidine.