Factors Associated with Types and Intensity of Postoperative Pain following Gynecological Laparoscopic Surgery: A Cross-Sectional Study

Hsien, Chia-Fen; Wang, Chiu‐Lin; Long, Cheng‐Yu; Chen, Yung-Hung; Lee, Winter Yu-Ning; Chen, Shih‐Chin; Lin, Kun‐Ling; Jeng, Cherng-Jye; Tsai, Eing Mei; Tang, Feng-Hsiang

doi:10.1155/2017/2470397

Cited by 11 publications

(13 citation statements)

References 15 publications

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“…Pain after laparoscopy may be at the incision site-'surgical wound pain' and 'nonsurgical wound pain'-or be located in the supraclavicular area (referred pain) [23]. Carbon dioxide, which is necessary to create the pneumoperitoneum, is the main cause behind postoperative shoulder pain because it affects the diaphragm and stimulates the phrenic nerve, resulting in pain in the fourth neck dermatome [24,25].…”

Section: Discussionmentioning

confidence: 99%

Relationship of Postoperative Pain and PONV after Minimally Invasive Surgery with the Serotonin Concentrations and Receptors’ Gene Polymorphisms

Ignaszak-Kaus

Dulęba

Mrozikiewicz

et al. 2021

JPM

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(1) Background: there is a steady increase in the number of procedures performed via minimally invasive surgery, which have many benefits, but post-operative nausea and vomiting (PONV) and significant pain are still a common problem (2) Methods: 300 infertile women (18–40 years old) undergoing minimal invasive surgery. Interventions: laparoscopy and hysteroscopy performing, evaluation of postoperative symptoms, serotonin concentrations assessment, identify genetic polymorphisms. (3) Results: serotonin concentrations were significantly lower among women who required opioids (p = 0.006). The presence of the GG genotype in the rs6318 polymorphism of the 5HTR2C gene had a protective effect on PONV (OR = 0.503; C.I. = [0.300–0.841]; p = 0.008), when the GG variant of the rs11214763 polymorphism of the 5HTR3B gene, when the risk of PONV was 1.65-fold higher (OR = 1.652; C.I. = [1.003–2.723]; p = 0.048). Pain intensity was significantly higher among women with GG genotype of the rs6296 polymorphism of the 5HTR1B gene (OR = 1.660; C.I. = [1.052–2.622]; p = 0.029).; (4) Conclusions: the evaluation of serotonin concentration predicts requirement for opioid pain relief medication. The polymorphisms of the serotonin receptors affect the intensity of postoperative complaints.

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Section: Discussionmentioning

confidence: 99%

Relationship of Postoperative Pain and PONV after Minimally Invasive Surgery with the Serotonin Concentrations and Receptors’ Gene Polymorphisms

Ignaszak-Kaus

Dulęba

Mrozikiewicz

et al. 2021

JPM

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“…The primary outcome of this study was pain evaluated by the patient based on verbal numerical rating scale (0-10) at Post Anesthetic Care Unit after laparoscopic surgery. The scores were categorized into no pain (0), mild pain (1-3), moderate pain (4-6), and severe pain (7)(8)(9)(10). Then patients were divided into two groups, no/mild pain and moderate to severe pain.…”

Section: Methodsmentioning

confidence: 99%

“…These studies reported young age 4 , pre-existing pain 5 , female 6,7 , and obese patients which are patient factors associated pain. However few studies documented surgical factors including duration of surgery, port site and intra-abdominal pressure 8,9 , which would be correlated with pain after laparoscopic procedures. Moreover, anesthetic factors such as local infiltration anesthesia 10 , paracetamol 11 , and parecoxib 12 would be the prophylactic factors to reduce pain.…”

Section: Introductionmentioning

confidence: 99%

Factors Associated with Moderate to Severe Pain after Laparoscopic Surgery

Kunapaisal

Pattaravit

Thongsuksai

2021

J Health Sci Med Res

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Objective: The aim of this study was to describe associated factors of patients with moderate to severe pain after laparoscopic abdominal surgery in Post Anesthetic Care Unit.Material and Methods: This retrospective study included patients who underwent laparoscopic abdominal surgeries (bariatric, colorectal, gynecological, urological, and upper gastrointestinal surgery) between February and July 2019. Demographic data were retrieved from the anesthetic records. Pain score was evaluated by self- rating using verbal numerical rating scale (0-10). Logistic regression was used to obtain independent risk factors of moderate to severe (score 4-10) pain against no or mild pain.Results: Two-hundred and ten patients were included. The incidence of moderate (score 4-6) to severe pain (score 7-10) was 50.0%. Those who suffered from moderate to severe pain required higher consumption of analgesic drugs in recovery room than the other groups, however durations of hospitalization were not different between the two groups (p-value=0.329). This was because the highest intensity of pain was in the first postoperative day. A multivariate logistic regression analysis revealed that abdominal pressure more than 12 mmHg (odd ratio (OR)=1.84, 95% confidence interval (CI) 0.8-4.22, p-value=0.153), and operation time more than 3 hours (OR 1.49, 95% CI 0.86-2.61, p-value=0.158) were independent risk factors of moderate to severe pain after laparoscopic procedureConclusion: High intra-abdominal pressure (≥12 mmHg) and prolonged operation time (>3 hours) are the independent risk factors of moderate and severe pain in laparoscopic surgery.

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“…Although laparoscopy is the preferred approach due to the lower complications, such as better wound healing, lower infection rates, less blood loss, better recovery, and shorter hospital stay (2), this type of surgery has its own complications (3). One of the important sources of pain after laparoscopic gynecological surgery is postoperative shoulder pain, observed in up to 85% of patients, lasting up to 72 h after surgery and causing great discomfort for patients (4). Postoperative nausea and vomiting (PONV) is another important complication after surgical procedures (5), observed in 20-40% of patients after gynecological laparoscopy (6).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Intraperitoneal Dexamethasone Infusion in Reduction of Shoulder Pain and Nausea/Vomiting After Gynecological Laparoscopy

Nouri

Arab

Lotfpour

2021

Fertility Gynecology Andrology

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Background: The reduction of shoulder pain and postoperative nausea and vomiting (PONV), causing great discomfort for patients after gynecological laparoscopy, requires preventive or treatment strategies. Objectives: The present study aimed to determine the efficacy of intraperitoneal (IP) dexamethasone in the reduction of shoulder pain and PONV after gynecological laparoscopy. Methods: In this double-blind, randomized clinical trial, 130 consecutive patients undergoing gynecological laparoscopy were randomly assigned to two groups of 65 patients within May 2015 to May 2016. One group received 16 mg IP dexamethasone before the end of the surgery, and the other group received the placebo (i.e., the IP infusion of distilled water). Patients' age and body mass index (BMI), and surgery duration were recorded in this study. The severity of shoulder pain was evaluated by the visual analog scale (VAS) at recovery and 2, 6, 12, and 24 h after the surgery. Moreover, the need for opioid use and PONV were recorded within the first 24 h after the surgery. The study outcomes were compared between the two study groups and among the different intervals using SPSS software (version 21). Results: The groups had similar demographics (i.e., age and BMI) and mean surgery duration (P > 0.05). The mean values of VAS scores of the intervention group were lower than those of the placebo group at five intervals (P = 0.001). The frequency of opioid use was significantly lower in the dexamethasone group (P = 0.010). In addition, 20% and 60% of the patients in the dexamethasone and placebo groups had PONV, respectively (P < 0.001). Conclusions: The IP dexamethasone is effective in the reduction of shoulder pain and nausea/vomiting after gynecological laparoscopy and can significantly reduce opioid requirement within the first 24 h after surgery; however, IP dexamethasone does not increase surgery duration. Therefore, it is recommended to use this technique during gynecological laparoscopy.

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Factors Associated with Types and Intensity of Postoperative Pain following Gynecological Laparoscopic Surgery: A Cross-Sectional Study

Cited by 11 publications

References 15 publications

Relationship of Postoperative Pain and PONV after Minimally Invasive Surgery with the Serotonin Concentrations and Receptors’ Gene Polymorphisms

Relationship of Postoperative Pain and PONV after Minimally Invasive Surgery with the Serotonin Concentrations and Receptors’ Gene Polymorphisms

Factors Associated with Moderate to Severe Pain after Laparoscopic Surgery

Efficacy of Intraperitoneal Dexamethasone Infusion in Reduction of Shoulder Pain and Nausea/Vomiting After Gynecological Laparoscopy

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