Rettenmaier Mark A, Micha John P, Lopez Katrina L, Wilcox Amber M, Goldstein Bram H
1 Gynecologic Oncology Associates, Newport Beach, CA, USA.
2 The Women's Cancer Research Foundation, Newport Beach, CA, USA.
Surg Innov. 2017 Dec;24(6):552-556. doi: 10.1177/1553350617718080. Epub 2017 Jul 5.
Postoperative shoulder pain is a condition associated with laparoscopic surgery and presumably attributed to residual carbon dioxide (CO) in the abdomen. The intent of the current prospective, observational study was to assess the efficacy of abdominal compression in mitigating this painful complication.
We recruited 30 patients who were treated with laparoscopic surgery for the management of gynecologic disease. All study participants underwent abdominal compression to evacuate the CO associated with their pneumoperitoneum. Postoperatively, the subjects' pain intensity was measured via the visual analogue scale at 12, 24, and 48 hours.
The patients' mean postoperative visual analogue scale pain scores were the highest during the initial 12 hours (1.93), and thereafter, steadily declined at 24 hours (0.73) and 48 hours (0.70) ( P = .045). Furthermore, toxicity was reasonable, with only 20% of subjects who reported grade ≤2 nausea and vomiting.
Abdominal compression is a relatively safe procedure that appears to sufficently evacuate residual CO, thereby reducing the severity of laparoscopic surgery induced shoulder pain.
术后肩部疼痛是一种与腹腔镜手术相关的病症，可能归因于腹腔内残留的二氧化碳（CO）。本前瞻性观察性研究的目的是评估腹部压迫在减轻这种疼痛并发症方面的疗效。
我们招募了30例接受腹腔镜手术治疗妇科疾病的患者。所有研究参与者均接受腹部压迫以排出与气腹相关的CO。术后，在12、24和48小时通过视觉模拟量表测量受试者的疼痛强度。
患者术后视觉模拟量表疼痛平均评分在最初12小时最高（1.93），此后在24小时（0.73）和48小时（0.70）稳步下降（P = 0.045）。此外，毒性合理，只有20%的受试者报告有≤2级恶心和呕吐。
腹部压迫是一种相对安全的操作，似乎能充分排出残留的CO，从而减轻腹腔镜手术引起的肩部疼痛的严重程度。
