Anaesthesia and Critical Care Medicine Journal (ACCMJ)

ISSN: 2577-4301

Research Article

Risk Factors and Prevention Measures for Specific Shoulder Pain in Laparoscopic Surgery

Authors: Ammari Smail, Tibiche A, Taieb M

DOI: 10.23880/accmj-16000238


Introduction: Shoulder pain is a specific discomfort associated with laparoscopic procedures. Its pathophysiology remains poorly understood and hypothetical. Several factors have been suggested as potential triggers for this pain. The aim of our study is to assess post-laparoscopic surgery shoulder pain and investigate the risk factors for its occurrence and methods of prevention. Materials and Methods: This is a descriptive and prospective study involving 337 patients who underwent laparoscopic surgery for acute non-traumatic abdominal emergencies between February 2018 and October 2021. Results: Among the 337 operated patients, 190 were females (56.4%), with a mean age of 38 years ± 15 years. Shoulder pain was present in 73 patients (21.6%). Its intensity was low in the majority of cases. The average duration of pain was 1.99 ± 1.09 days. The operative time threshold at which pain began to appear was 34.5 minutes. Pain was less intense in patients who underwent drainage at the end of the procedure (p-value = 0.026 on postoperative day 1). Moreover, there was no correlation between the duration of postoperative shoulder pain and drainage (P= 0.482). Conclusion: The insufflation of CO2 to create pneumoperitoneum and the tensioning of the nerves in the abdominal wall were the factors responsible for shoulder pain in our study. Drainage at the end of the procedure reduced the intensity of the pain but did not prevent its occurrence.

Keywords: CO2; Laparoscopy; Postoperative Pain; Shoulder Pain

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