Background: Laparoscopic cholecystectomy is the treatment of choice for symptomatic colelithiasis, it is also the most common laparoscopic procedure performed all over the world and in U.S.A. Methods: This is a prospective, randomized study comparing the (Group A) low pressure pneumoperitoneum (8-10 mmhg) with preemptive analgesia versus (Group B) standard pressure pneumoperitoneum (12-14mmhg) without preemptive analgesia. Results: Mean age in group A was 39.14 ± 6.12 Yrs and in group B was 40.34 ± 6.48Yrs. 14 male & 36 female were in group A and 13 male & 37 female were in group B. 58.00% patients in group A and 62.00% patients in group B were from rural area. Mean duration of surgery 46.2 ± 2.80 Mint in group A and Mean duration of surgery 44.90 ± 2.60 Mint in group B. The duration of surgery was less in group B compare to group A. VAS score at 4 hours in group-A was 6.2 ± 0.82 and in group-B was 6.8 ± 0.98. The difference in both group was statistically highly significant (p-value<0.001). VAS score at 12 hours in group-A was 4.1 ± 0.61 and in group-B was4.3 ± 0.52. The difference in both group was statistically highly Insignificant (p-value>0.05). VAS score at 24 hours in group-A was 2.52 ± 0.22 and in group-B was 2.6 ± 0.20. The difference in both group was statistically highly Insignificant (p-value>0.05). The need of analgesia in group A was 70mg/day and group B was 110mg/day. The difference in both group was statistically highly significant (p-value<0.001). Mean time of hospital stay in group B was 53.2 ± 2.40 Hrs and in group A was 51.8 ± 2.38 Hrs. The difference in both group was statistically highly significant (p-value<0.001). Conclusion: low pressure pneumoperitoneum (8-10 mmhg) with preemptive analgesia to be better than standard pressure pneumoperitoneum (12-14mmhg) without preemptive analgesia in terms of duration of surgery, lower incidence of pain and hospital stay.

Keywords: Pneumoperitoneum; Laparoscopic cholecystectomy; Colelithiasis.