Time Characteristics of Shoulder Pain after Laparoscopic Surgery

Xinyou Li, Kezhong Li, Xinyou Li, Kezhong Li

Abstract

Objective: To explore the time characteristics of shoulder pain after laparoscopic gynecological operation.

Methods: We conducted prospective clinical observations and literature review. We studied 442 cases of laparoscopic gynecological surgery. We used a visual analogue scale to evaluate the pain of patients at different time points after operation. We searched the English literature of shoulder pain after gynecological laparoscopic surgery. The observation time points of these studies included 12-24 hours or the first day after surgery, and at least one time point before this time point.

Results: The total incidence of shoulder pain was 68%. More than 90% of patients begin to feel shoulder pain on the first day after surgery, not on the day of surgery. 26 articles observed the severity of postlaparoscopic shoulder pain (PLSP) at different time points, of which 17 articles found that the intensity of the shoulder pain peaked at 12-24 hours or the first day after operation.

Discussion: The occurrence of PLSP presents obvious time characteristics. The incidence and severity of PLSP peaked on the first day or 12-24 hours after operation. To prevent and treat PLSP better, clinicians should make a more in-depth study according to the time characteristics of PLSP.

Keywords: Laparoscopy; Shoulder pain; Temporal characteristics.

Conflict of interest statement

Conflicts of Interest: Dr. Kezhong Li declares no conflict of interest.

© 2021 by SLS, Society of Laparoscopic & Robotic Surgeons.

References

    1. Mouton WG, Bessell JR, Otten KT, Maddern GJ. Pain after laparoscopy. Surg Endosc. 1999;13(5):445–448.
    1. Liu H, Ma C, Zhang X, et al. . Combined incisional ropivacaine infiltration and pulmonary recruitment manoeuvre for postoperative pain relief after diagnostic hysteroscopy and laparoscopy. Chin Med J. 2014;127:825–829.[24571870]
    1. Kerimoglu OS, Yilmaz SA, Pekin A, et al. . Effect of drainage on postoperative pain after laparoscopic ovarian cystectomy. J Obstet Gynaecol. 2015;35(3):287–289.
    1. Abbott J, Hawe J, Srivastava P, Hunter D, Garry R. Intraperitoneal gas drain to reduce pain after laparoscopy: randomized masked trial. Obstet Gynecol. 2001;98(1):97–100.
    1. Bogani G, Uccella S, Cromi A, et al. . Low vs standard pneumoperitoneum pressure during laparoscopic hysterectomy: prospective randomized trial. J Minim Invasive Gynecol. 2014;21(3):466–471.
    1. Sharami SH, Sharami MB, Abdollahzadeh M, Keyvan A. Randomised clinical trial of the influence of pulmonary recruitment manoeuvre on reducing shoulder pain after laparoscopy. Obstet Gynaecol. 2010;30(5):505–510.
    1. Shen CC, Wu MP, Lu CH, et al. . Effects of closed suction drainage in reducing pain after laparoscopic-assisted vaginal hysterectomy. J Am Assoc Gynecol Laparosc. 2003;10(2):210–214.
    1. Zhang H, Shu H, Yang L, et al. . Multiple-, but not single-, dose of parecoxib reduces shoulder pain after gynecologic laparoscopy. Int J Med Sci. 2012;9(9):757–765.
    1. Phelps P, Cakmakkaya OS, Apfel CC, Radke OC. A simple clinical maneuver to reduce laparoscopy-induced shoulder pain: a randomized controlled trial. Obstet Gynecol. 2008;111(5):1155–1160.
    1. Chaichian S, Moazzami B, Haghgoo A, Sheibani K. A new approach to an old concept for reducing shoulder pain caused by gynecological laparoscopy. J Reprod Infertil. 2018;19:56–60.
    1. Swift G, Healey M, Varol N, Maher P, Hill D. A prospective randomised double-blind placebo controlled trial to assess whether gas drains reduce shoulder pain following gynaecological laparoscopy. Aust N Z J Obstet Gynaecol. 2002;42(3):267–270.
    1. Sroussi J, Elies A, Rigouzzo A, et al. . Low pressure gynecological laparoscopy (7 mm Hg) with AirSeal® System versus a standard insufflation (15 mm Hg): a pilot study in 60 patients. J Gynecol Obstet Hum Reprod. 2017;46(2):155–158.
    1. Valadan M, Banifatemi S, Yousefshahi F. Preoperative gabapentin to prevent postoperative shoulder pain after laparoscopic ovarian cystectomy: a randomized clinical trial. Anesthesiol Pain Med. 2015;5:e31524.10.5812/aapm.31524
    1. Leelasuwattanakul N, Bunyavehchevin S, Sriprachittichai P. Active gas aspiration versus simple gas evacuation to reduce shoulder pain after diagnostic laparoscopy: a randomized controlled trial. J Obstet Gynaecol Res. 2016;42(2):190–194.
    1. Herrmann A, De Wilde RL. Insufflation with humidified and heated carbon dioxide in short-term laparoscopy: a double-blinded randomized controlled trial. BioMed Res Int. 2015;2015:412618.
    1. Radosa JC, Radosa MP, Mavrova R, et al. . Five minutes of extended assisted ventilation with an open umbilical trocar valve significantly reduces postoperative abdominal and shoulder pain in patients undergoing laparoscopic hysterectomy. Eur J Obstet Gynecol Reprod Biol. 2013;171(1):122–127.
    1. Hoyer-Sørensen C, Vistad I, Ballard K. Is single-port laparoscopy for benign adnexal disease less painful than conventional laparoscopy? A single-center randomized controlled trial. Fertil Steril. 2012;98(4):973–979.
    1. Bunyavejchevin S, Prayoonwech C, Sriprajittichai P. Preemptive analgesic efficacy of parecoxib vs placebo in infertile women undergoing diagnostic laparoscopy: randomized controlled trial. J Minim Invasive Gynecol. 2012;19(5):585–588.
    1. Chou YJ, Ou YC, Lan KC, et al. . Preemptive analgesia installation during gynecologic laparoscopy: a randomized trial. J Minim Invasive Gynecol. 2005; 12(4):330–335.
    1. Narchi P, Benhamou D, Fernandez H. Intraperitoneal local anaesthetic for shoulder pain after day-case laparoscopy. Lancet. 1991;338(8782–8783):1569–1570.
    1. Ghezzi F, Cromi A, Siesto G, et al. . Minilaparoscopic versus conventional laparoscopic hysterectomy: results of a randomized trial. J Minim Invasive Gynecol. 2011;18(4):455–461.
    1. Asgari Z, Rezaeinejad M, Hosseini R, et al. . Spinal anesthesia and spinal anesthesia with subdiaphragmatic lidocaine in shoulder pain reduction for gynecological laparoscopic surgery: a randomized clinical trial. Pain Res Manag. 2017;2017:1721460.
    1. Tharanon C, Kampitak K. The effect of peritoneal gas drain on postoperative pain in benign gynecologic laparoscopic surgery: a double-blinded randomized controlled trial. Int J Womens Health. 2016;8:373–379.
    1. Choi JB, Kang K, Song MK, et al. . Pain characteristics after total laparoscopic hysterectomy. Int J Med Sci. 2016;13(8):562–568.
    1. Korell M, Schmaus F, Strowitzki T, Schneeweiss SG, Hepp H. Pain intensity following laparoscopy. Surg Laparosc Endosc. 1996;6(5):375–379.
    1. Suginami R, Taniguchi F, Suginami H. Prevention of postlaparoscopic shoulder pain by forced evacuation of residual CO2. JSLS. 2009;13:56–59.
    1. Madsen MV, Istre O, Staehr-Rye AK, et al. . Postoperative shoulder pain after laparoscopic hysterectomy with deep neuromuscular blockade and low-pressure pneumoperitoneum: a randomised controlled trial. Eur J Anaesthesiol. 2016;33(5):341–347.
    1. Goldberg JM, Maurer WG. A randomised comparison of gasless laparoscopy and CO2 pneumoperitoneum. Obstet Gynecol. 1997;90(3):416–420.
    1. Alexander JI. Pain after laparoscopy. Br J Anaesth. 1997;79(3):369–378.
    1. Woolf CJ, Chong MS. Preemptive analgesia–treating postoperative pain by preventing the establishment of central sensitization. Anesth Analg. 1993;77(2):362–379.
    1. Kissin I. Preemptive analgesia: why its effect is not always obvious. Anesthesiology. 1996;84(5):1015–1019.

Source: PubMed

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