Abstract:

Objective To investigate the differential efficacy of pressurized oxygen administration based on body mass index(BMI) stratification in obese patients with postoperative shoulder pain after laparoscopic cholecystectomy. Method 80 patients with shoulder pain after laparoscopic cholecystectomy in Hechi people's Hospital from January 2021 to December 2023 were selected and randomly divided into control group and experimental group, 40 cases in each group. The control group received conventional oxygen inhalation and pain management, and the experimental group received stratified hyperbaric oxygen (BMI 30 ～＜ 35kg/m²: 5cmH2O;

BMI ≥ 35kg/m²: 7cmH2O) combined with abdominal breathing training. Blood gas analysis, postoperative pain and complications were compared between the two groups before and after pressurized oxygen therapy. Result After the intervention, the arterial blood carbon dioxide partial pressure (PaCO2) of the two groups decreased significantly compared with that before the intervention, and the reduction of PaCO2 in the experimental group was significantly higher than that in the control group (P ＜ 0.05); There was no significant difference in the increase of arterial partial pressure of oxygen (PaO2) between the two groups (P ＞ 0.05). The digital grading score at 48 hours and 72 hours after operation in the experimental group was significantly lower than that in the control group, and the effective rate of pain relief (87.50%) was significantly higher than that in the control group (65.00%), with significant differences (P ＜ 0.05). There was no significant difference in the total incidence of complications between the experimental group (12.50%) and the control group (17.50%) (P=0.531). After the intervention, the overall comfort score of the experimental group was (2.16±0.63), which was lower than that of the control group (3.85±0.72), and the difference was significant (t=11.171, P ＜ 0.001). Conclusion Hyperbaric oxygenation based on BMI stratification can effectively improve postoperative ventilation function and accelerate pain relief in obese patients, with good safety.

Key words: Body mass index, Pressurized oxygen supply, Laparoscopic, Postoperative, Shoulder pain, Obesity