The use of a peritoneal gas drain following gynecological laparoscopy: a systematic review

Craciunas, Laurentiu; Stirbu, Laura; Tsampras, Nikolaos

doi:10.1016/j.ejogrb.2014.04.012

Cited by 13 publications

(10 citation statements)

References 15 publications

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“…Many intervention clinical studies aimed at solving PLSP have been conducted 24 – 32 . Unfortunately, these intervention studies have often found quite varied and sometimes even conflicting results regarding the effectiveness of these interventions, including using drainage 19 , 32 – 34 , intraperitoneal instillation of local anesthetics 13 , 35 – 37 , pulmonary recruitment manoeuvre 38 – 40 , gasless laparoscopy 41 – 43 , warm and humidified dioxide 44 – 46 , low-pressure pneumoperitoneum 30 , 31 , 47 , intraperitoneal normal saline infusion 48 , 49 and drugs preventatively or therapeutically 20 , 50 , 51 . However, few studies have attempted to identify the risk factors for PLSP 52 .…”

Section: Introductionmentioning

confidence: 99%

The risk of shoulder pain after laparoscopic surgery for infertility is higher in thin patients

Tian

et al. 2021

Sci Rep

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Postlaparoscopic shoulder pain (PLSP) is a common clinical problem that needs to be addressed by medical professionals who are currently perform laparoscopic surgeries. The purpose of this study was to determine the perioperative clinical factors and demographic characteristics associated with PLSP. A prospective observational study was performed with 442 inpatients undergoing laparoscopic surgery for infertility. The pain visual analogue scale was used as the measuring instrument. To identify the predictors of PLSP, we performed multivariate conditional logistic regression. PLSP was correlated with body mass index (BMI, odds ratio = 0.815). The incidence of shoulder pain and more severe shoulder pain in patients with a lower BMI was significantly higher than it was in patients with a higher BMI, and BMI was significantly negatively correlated with PLSP. Most of the patients (95%) began to experience shoulder pain on the first postoperative day, and it rarely occurred on the day of surgery. Patients with lower BMI presented a higher risk of reporting shoulder pain on the first postoperative day. We should identify high-risk patients in advance and make specific treatment plans according to the characteristics of their symptoms.

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Section: Introductionmentioning

confidence: 99%

The risk of shoulder pain after laparoscopic surgery for infertility is higher in thin patients

Tian

et al. 2021

Sci Rep

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“…In a systematic review, Craciunas et al 16 concluded that there was little evidence to support the use of intraperitoneal gas drain in reducing postoperative pain and suggested that future study was required to minimize the bias resulting from operating time and using the analgesic dosage as an objective measure for pain evaluation. We, thus, conducted this study according to those guidelines.…”

Section: Discussionmentioning

confidence: 99%

“… 5 , 7 , 14 , 15 Recently, a systematic review mentioned that there was little evidence to support the effectiveness of intraperitoneal gas drain in reducing postoperative pain. 16 …”

Section: Introductionmentioning

confidence: 99%

The effect of peritoneal gas drain on postoperative pain in benign gynecologic laparoscopic surgery: a double-blinded randomized controlled trial controlled trial

Tharanon¹,

Khampitak²

2016

IJWH

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ObjectivesTo compare the effect of peritoneal gas drain on postoperative pain in benign gynecologic laparoscopic surgery and the amount of postoperative analgesic dosage.MethodsThe trial included 45 females who had undergone operations during the period December 2014 to October 2015. The patients were block randomized based on operating time (<2 and ≥2 hours). The intervention group (n=23) was treated with postoperative intraperitoneal gas drain and the control group (n=22) was not. The mean difference in scores for shoulder, epigastric, suprapubic, and overall pain at 6, 24, 48 hours postoperatively were statistically evaluated using mixed-effect restricted maximum likelihood regression. The differences in the analgesic drug usage between the groups were also analyzed using a Student’s t-test. The data were divided and analyzed to two subgroups based on operating time (<2 hours, n=20; and $2 hours, n=25).ResultsThe intervention had significantly lower overall pain than the control group, with a mean difference and 95% confidence interval at 6, 24, and 48 hours of 2.59 (1.49–3.69), 2.23 (1.13–3.34), and 1.48 (0.3–2.58), respectively. Correspondingly, analgesic drug dosage was significantly lower in the intervention group (3.52±1.47 mg vs 5.72±2.43 mg, P<0.001). The three largest mean differences in patients with operating times of ≥2 hours were in overall pain, suprapubic pain at 6 hours, and shoulder pain at 24 hours at 3.27 (1.14–5.39), 3.20 (1.11–5.26), and 3.13 (1.00–5.24), respectively. These were greater than the three largest mean differences in the group with operating times of <2 hours, which were 2.81 (1.31–4.29), 2.63 (0.51–4.73), and 2.02 (0.68–3.36). The greatest analgesic drug requirement was in the control group with a longer operative time.ConclusionThe use of intraperitoneal gas drain was shown to reduce overall postoperative pain in benign gynecologic laparoscopic surgery. The effects were higher in patients who had experienced longer operating times.

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“…With regard to reducing pain from CO 2 gas in the peritoneal cavity after laparoscopic surgery, we would like to add another method-inserting a gas drain for 4 hours postoperatively. A number of randomized controlled trials have been reported [2], including some with mixed or inconclusive results. The latest study, by Tharanon et al [3], showed a reduction in overall pain and analgesic use in the group with gas drains, with greater effects with longer operating times.…”

Section: Regarding "Managing Postoperative Pain After Minimally Invasive Gynecologic Surgery In the Era Of The Opioid Epidemic"mentioning

confidence: 99%

“…Based on the results of the recent randomized controlled trial reported by Tharanon et al [1], leaving a peritoneal drain in place for 6 hours after benign laparoscopic gynecologic surgery showed promise for significantly decreasing postoperative pain in the 45 patients studied. In a recent Cochrane Review on this topic, published in January 2019, the authors noted that the use of an intraperitoneal drain may reduce postoperative shoulder tip pain, but with the caveat that the available evidence is of only low to very low quality [2].…”

mentioning

confidence: 99%

Regarding “Managing Postoperative Pain After Minimally Invasive Gynecologic Surgery in the Era of the Opioid Epidemic”

Cheng¹,

Healey²,

Dior³

2019

Journal of Minimally Invasive Gynecology

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The use of a peritoneal gas drain following gynecological laparoscopy: a systematic review

Cited by 13 publications

References 15 publications

The risk of shoulder pain after laparoscopic surgery for infertility is higher in thin patients

The risk of shoulder pain after laparoscopic surgery for infertility is higher in thin patients

The effect of peritoneal gas drain on postoperative pain in benign gynecologic laparoscopic surgery: a double-blinded randomized controlled trial controlled trial

Regarding “Managing Postoperative Pain After Minimally Invasive Gynecologic Surgery in the Era of the Opioid Epidemic”

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