[Postlaparoscopic pain syndrome. Results of a prospective, randomized study]

Abstract

The so-called post-laparoscopic algesia is a specific impairment of about 63% of the patients who undergo laparoscopic surgical operations. This impairment takes the form of mild to moderate shoulder pain. Eliminating the causes of pain has a clear advantage over symptomatic treatment using analgetics, a fact worth a good consideration especially with the post-operative sojourn at the hospital becoming shorter and shorter. In a prospective controlled study, involving 42 patients subdivided into four groups namely, higher or lower insufflation pressures, chemically inert insufflation gas and control groups; the use of analgetics, lung function, operation duration, amount of insufflated gas, intraperitoneal pH-values and post-operative complications in the various subgroups were compared to each other with regard to post-operative pain perception. The results did not show any significant differences among the groups regarding the main parameters like pH-value or different insufflation pressures etc. These results led to the termination of the study based on the raised criteria since we anticipated the actual cause of the shoulder pain to be due to an unknown factor. By the evaluation of the individual data, it became apparent that, the pains increase with increasing gas consumption, a fact which led to assumption that the pains are caused by a physical effect such as the cooling of the peritoneum.