Department of Gynecology, People's Hospital of Shapingba District, Chongqing, China.
Department of Obstetrics and Gynecology, Chongqing Health Center for Women and Children (Women and Children's Hospital of Chongqing Medical University), Chongqing, China.
Acta Obstet Gynecol Scand. 2023 Jan;102(1):99-104. doi: 10.1111/aogs.14477. Epub 2022 Nov 2.
Shoulder pain is one of the most common complications after laparoscopy. Previous studies have found a number of methods to reduce shoulder pain after laparoscopic surgery, but these methods have not been targeted to specific populations. The purpose of this study was to identify people who are more likely to develop shoulder pain.
A total of 203 patients underwent laparoscopy for benign gynecological diseases between July 2020 and February 2021. Patients were divided into two groups according to the Chinese overweight standard, body mass index less than 24 kg/m group and 24 kg/m or more group. The baseline characteristics and intraoperative data between the two groups were compared. The intensity of the shoulder pain was quantified using a visual analog scale (VAS).
The incidence and the VAS scores of shoulder pain were significantly higher in the less than 24 kg/m group (63.64% vs 38.03%, p < 0.001 in incidence; median 5 (interquartile range [IQR] 3-7) vs 3 (IQR 2-5), p < 0.001 in VAS scores), and the chance of shoulder pain within 24 hours after laparoscopy was higher in the less than 24 kg/m group (89.29% vs 66.67%, p = 0.013). In univariate and multivariate logistic regression analysis, BMI less than 24 kg/m was an independent risk factor of shoulder pain after laparoscopic surgery (p = 0.001, p = 0.031, respectively). Shoulder pain scores were inversely correlated with BMI (r = -0.300, p = 0.001).
Patients with low body mass index are more likely to develop shoulder pain after laparoscopy, with earlier onset and higher pain scores.
肩部疼痛是腹腔镜术后最常见的并发症之一。既往研究发现了许多减少腹腔镜术后肩部疼痛的方法,但这些方法并未针对特定人群。本研究旨在确定更易发生肩部疼痛的人群。
203 例因良性妇科疾病接受腹腔镜手术的患者于 2020 年 7 月至 2021 年 2 月期间入组。根据中国超重标准将患者分为两组,体重指数(BMI)<24kg/m组和 24kg/m或以上组。比较两组患者的基线特征和术中数据。采用视觉模拟评分(VAS)量化肩部疼痛强度。
BMI<24kg/m组的肩部疼痛发生率和 VAS 评分均显著高于 BMI≥24kg/m组(发生率分别为 63.64% vs 38.03%,p<0.001;VAS 评分中位数分别为 5(四分位距 [IQR] 3-7) vs 3(IQR 2-5),p<0.001),且腹腔镜术后 24 小时内肩部疼痛的发生几率也更高(89.29% vs 66.67%,p=0.013)。单因素和多因素 logistic 回归分析显示,BMI<24kg/m 是腹腔镜术后肩部疼痛的独立危险因素(p=0.001,p=0.031)。肩部疼痛评分与 BMI 呈负相关(r=-0.300,p=0.001)。
低 BMI 患者腹腔镜术后更易发生肩部疼痛,且发病更早、疼痛评分更高。