Department of Gynecology, Campus Bio-Medico University Hospital Foundation, Rome, Italy.
Eur Rev Med Pharmacol Sci. 2023 Jul;27(14):6800-6808. doi: 10.26355/eurrev_202307_33151.
OBJECTIVE: Laparoscopic surgery offers many advantages compared to invasive surgery but one of the main problems is postoperative pain, partially resulting from the peritoneal inflammatory process mediated by inflammatory cytokines. The rationale of this study is that intraperitoneal washing could remove inflammatory mediators that are the cause of postoperative pain and could help in the removal of CO2 from the abdominal cavity. This article aims to analyze the effects of peritoneal lavage in the reduction of postoperative shoulder pain. PATIENTS AND METHODS: 277 patients enrolled to undergo laparoscopic gynecologic surgery were included in the study. Women are randomized into two groups, according to the use or non-use of peritoneal lavage with saline solution at the end of laparoscopic gynecological major procedures. RESULTS: Data show that the peritoneal lavage can significantly reduce postoperative pain in the first 36 hours after surgery, as well as patients' requests for analgesics: during the first 3 postoperative days, requests for paracetamol were lower in the YW (Yes Washing) group than the NW (No Washing) group (77 vs. 101; p<0.05); similar results are obtained considering ketorolac administration (62 vs. 71; p<0.05). CONCLUSIONS: Peritoneal lavage after gynecological laparoscopic procedures may be effective in the reduction of postoperative pain and use of analgesics.
目的:与传统手术相比,腹腔镜手术具有许多优势,但术后疼痛是主要问题之一,部分原因是炎症细胞因子介导的腹膜炎症过程。本研究的原理是,腹腔冲洗可以清除引起术后疼痛的炎症介质,并有助于从腹腔中清除 CO2。本文旨在分析腹腔灌洗对减轻术后肩部疼痛的效果。
患者和方法:本研究纳入了 277 名接受腹腔镜妇科手术的患者。女性根据在腹腔镜妇科大手术后是否使用生理盐水进行腹腔灌洗随机分为两组。
结果:数据显示,腹腔灌洗可显著减轻术后 36 小时内的疼痛,以及患者对镇痛药的需求:术后第 3 天内,YW(Yes Washing,灌洗)组比 NW(No Washing,未灌洗)组对扑热息痛的需求较低(77 比 101;p<0.05);考虑到酮咯酸的使用,也得到了类似的结果(62 比 71;p<0.05)。
结论:妇科腹腔镜手术后进行腹腔灌洗可能有助于减轻术后疼痛和镇痛药的使用。
Eur Rev Med Pharmacol Sci. 2023-7
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