Ecrease Post Laparoscopic Shoulders Pain With Slow Deflation of Abdominal Gas

Amir Vejdan, MD, Kataneh Dadashi, RN. Immam Reza Hopsital

Background
Shoulder pain is a common complaint following laparoscopic surgery and the incidence of Shoulder pain is generally about 35% of patients following laparoscopic surgeries, but it is more frequent after some specific type of laparoscopic surgeries like as Nissen fundoplication and laparoscopic adjustable gastric band. This investigation evaluates the role of slow deflation of abdominal gas in decreasing the severity and the incidence of this problem.

Patients and method
78 patients with uncomplicated gall stone and early phase of acute cholecystitis were randomly divided in two groups. In control group (38 patients), Ports were removed rapidly and gas deflated in less than 10 seconds, but in main group (40 patients), gas was deflated with a slow rate in 3 minutes. Patients were fallowed for 8 weeks after operation and the incidence and severity of pain were evaluated and compared with each other.
 

Results
The incidence of post laparoscopic shoulder pain was 8% and 34% in main group and control groups, respectively (P<0.05). Pain score system shows less severity of pain in investigated group that can lead to decrease in analgesic prescription and dosage.
 

Recommendation
Decreasing the speed of abdominal gas deflation at the end of laparoscopic surgeries, can significantly decrease the incidence and severity of post laparoscopic shoulder pain.
 

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