[The post-laparoscopic pain syndrome (author's syndrome)]

Abstract

Following laparoscopy 18.5% of 200 patients had sub-phrenic pain on the day of operation and 28% had shoulder pain. During the night following the operation or on the first post-operative day 30.5% of the 200 patients had sub-phrenic pain and 54.5% had shoulder pain. A total of 63% of the patients had shoulder pain and 37.5% of the patients had sub-phrenic pain. 31.5% of the patients had a combination of both types of pain. Most of the sub-diaphragmatic pain was on the right side. In 93% of all patients the post-operative radiological investigation of the chest showed subphrenic gas. The remaining gas was aspirated and measured by infrared spectroscopy. All the remaining gas was carbon dioxide. The previously suggested absorption rates for carbon dioxide are probably too high. The transition of anaesthetic gas (e.g. N2O) through the peritoneum into the abdominal cavity as suggested by Hodgson, McClelland, and Newton was not detected in these measurements. The most likely cause of the post-laparoscopic pain syndrome is the effect of the volume of the remaining gas of the phrenic nerve.