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. 2020 Feb;46(2):310-313.
doi: 10.1111/jog.14156. Epub 2020 Jan 20.

Analysis of risk factors of postlaparoscopic shoulder pain

Shinichiro Wada  1 , Yoshiyuki Fukushi  1 , Mai Nishimura  1 , Sachiko Matsumoto  1 , Kanako Takimoto  1 , Kazuaki Imai  1 , Hajime Ota  1 , Yoko Tsuzuki  1 , Ayako Nakajima  1 , Takafumi Fujino  1
Affiliations

Analysis of risk factors of postlaparoscopic shoulder pain

Shinichiro Wada et al. J Obstet Gynaecol Res. 2020 Feb.

Abstract

Aim: Postlaparoscopic shoulder pain (SP), mainly caused by pneumoperitoneum with CO2 , sometimes suffers patients. This study was aimed to analyze the backgrounds of SP after gynecologic laparoscopy to clarify the risk of SP.

Methods: We analyzed answers of questionnaire about the degree of SP from 696 patients undergoing gynecologic laparoscopic surgery since 2014-2018. The questionnaire asks the degree of SP with numeric rating scale from 0 to 10, before and 3 days after operation. We defined cases in which postoperative score elevated more than three compared to preoperative score as SP(+). Analyzed backgrounds were age, parity, body mass index, operative method, operative duration and amount of hemorrhage. Statistics was performed by Fisher exact analysis as univariate analysis, and with logistic regression as multivariate analysis. All laparoscopic surgeries were performed under 10-12 mmHg in pressure of pneumoperitoneum with CO2 .

Results: Univariate analysis revealed categories 'less than 50 years old', and 'over 2 h' and 'over 3 h' in operative duration resulted significant high rate of SP(+). For these three factors, multivariate analysis resulted that "less than 50 years old' and 'over 3 h in operative duration' were significantly high.

Conclusion: This study suggests that 'less than 50 years' old and 'over 3 h in operative duration' were risk factors of postlaparoscopic SP. To protect from SP after laparoscopy, some countermeasures should be necessary especially for these patients.

Keywords: gynecologic laparoscopy; laparoscopy; operative duration; pneumoperitoneum; shoulder pain.

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