Shoulder Pain Following Laparoscopic Cholecystectomy: Factors Affecting the Incidence and Severity.
Summary of "Shoulder Pain Following Laparoscopic Cholecystectomy: Factors Affecting the Incidence and Severity."
Abstract Background: Laparoscopic cholecystectomy (LC) has become the standard treatment for gall bladder disease. However, despite its low degree of invasiveness, many patients complain of postoperative pain and postoperative nausea/vomiting. This study was planned to evaluate different factors affecting the incidence and severity of postoperative shoulder-tip pain after LC. Patients and Methods: One hundred consecutive patients who were treated for gall bladder stone by LC at the Gastroenterology Surgical Center, Mansoura University, Mansoura, Egypt, during the period from October 2008 to January 2010, were randomized according to different pnemoperitonum pressures (8, 10, 12, and 14 mm Hg). Each group comprises 25 patients. Results: There were 62 patients reported to have postoperative shoulder-tip pain during the first 12 hours after operation, which decreased to 9 patients on the 10th postoperative day. A significant difference was observed in the prevalence of pain at different pressures, 11% with low pressure and increased to 20% with high pressure. The incidence of shoulder-tip pain was significantly more in patients with a longer duration of the operation of >45 minutes at 12 hours (23 [76.7%] versus 39 [55.7%]; P = 0.04), at 24 hours (23 [76.7%] versus 29 [41.4%]; P = 0.009), and at 3 days postoperatively (19 [63.3%] versus 20 [28.6%]; P = 0.01). The volume of used gases during the operation had no effect on the incidence or severity of shoulder-tip pain after LC. Also, the use of intraoperative analgesics had no effect on the incidence or severity of shoulder-tip pain after LC. Conclusions: The origin of pain after LC is multifactorial. We recommend the use of the lower pressure technique during LC, and as patients with and without drains have similar incidence of postoperative shoulder pain, drains should not be used with the intention of preventing shoulder pain.
Affiliation
1 Faculty of Medicine, Gastroenterology Surgical Center, Mansoura University , Mansoura, Egypt .
Journal Details
This article was published in the following journal.
Name: Journal of laparoendoscopic & advanced surgical techniques. Part A
ISSN: 1557-9034
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20701547
- DOI: http://dx.doi.org/10.1089/lap.2010.0112
Medical and Biotech [MESH] Definitions
Cholecystectomy, Laparoscopic
Excision of the gallbladder through an abdominal incision using a laparoscope.
Shoulder Pain
Unilateral or bilateral pain of the shoulder. It is often caused by physical activities such as work or sports participation, but may also be pathologic in origin.
Bovine Respiratory Disease Complex
A multifactorial disease of CATTLE resulting from complex interactions between environmental factors, host factors, and pathogens. The environmental factors act as stressors adversely affecting the IMMUNE SYSTEM and other host defenses and enhancing transmission of infecting agents.
Brachial Plexus Neuritis
A syndrome associated with inflammation of the BRACHIAL PLEXUS. Clinical features include severe pain in the shoulder region which may be accompanied by MUSCLE WEAKNESS and loss of sensation in the upper extremity. This condition may be associated with VIRUS DISEASES; IMMUNIZATION; SURGERY; heroin use (see HEROIN DEPENDENCE); and other conditions. The term brachial neuralgia generally refers to pain associated with brachial plexus injury. (From Adams et al., Principles of Neurology, 6th ed, pp1355-6)
Pain, Referred
A type of pain that is perceived in an area away from the site where the pain arises, such as facial pain caused by lesion of the VAGUS NERVE, or throat problem generating referred pain in the ear.
PubMed Articles
Venous thromboembolism after laparoscopic cholecystectomy: clinical burden and prevention.
BACKGROUND: The clinical benefit of prophylaxis for venous thromboembolism (VTE) in laparoscopic cholecystectomy is unclear. This study aimed to assess the clinical burden of VTE and the efficacy and...
Drain after elective laparoscopic cholecystectomy. A randomized multicentre controlled trial.
BACKGROUND: Routine drainage after laparoscopic cholecystectomy is still debatable. The present study was designed to assess the role of drains in laparoscopic cholecystectomy performed for nonacutely...
BACKGROUND: Postoperative pain is the dominant complaint and the most common cause of delayed discharge after laparoscopic cholecystectomy. The aim of this study is to evaluate the potential of preope...
Chyle leak following laparoscopic cholecystectomy: a rare complication.
Gallstone disease is a highly prevalent condition which is commonly and safely treated by laparoscopic cholecystectomy. We present the third reported case of chyle leakage following laparoscopic chole...
Different anesthesia methods for laparoscopic cholecystectomy.
OBJECTIVES: The aim of the study was to compare the possibility of performing laparoscopic cholecystectomy using two different anesthesia procedures (spinal anesthesia versus general anesthesia). METH...
Clinical Trials
Risk Factors for Shoulder Pain and Emesis After Laparoscopic Cholecystectomy
Risk factors for postoperative shoulder pain after laparoscopic cholecystectomy were not clear. Moreover, risk factors for postoperative emesis specially for this surgery were not detailed...
SILS™ Port Laparoscopic Cholecystectomy Post Market Study
The objectives of this trial are: 1. to assess the feasibility and safety of performing SILS™ Port Laparoscopic Cholecystectomy 2. monitor and compare the outcomes of SI...
Intraperitoneal Analgesia After Laparoscopic Cholecystectomy
Although laparoscopic cholecystectomy is associated with less pain than contemporary open procedures; it is definitely not pain free and the magnitude of postoperative shoulder and abdomin...
Early Versus Delayed Surgery for Gallstone Pancreatitis
While there exists consensus among surgeons that patients with gallstone pancreatitis should undergo cholecystectomy to prevent recurrence, the precise timing of laparoscopic cholecystecto...
Comparison Between Low Pressure Versus High Pressure Laparoscopic Cholecystectomy
The physiological changes and postoperative pain are directly related with the degree of intra-abdominal pressure kept during the laparoscopy. The present study aims to examine difference...
