A Prospective,Observational Trial Assessing the Efficacy of Abdominal Compression in Reducing Laparoscopic-Induced Shoulder Pain

Abstract

Introduction: Postoperative shoulder pain is a condition associated with laparoscopic surgery and presumably attributed to residual carbon dioxide (CO₂) in the abdomen. The intent of the current prospective, observational study was to assess the efficacy of abdominal compression in mitigating this painful complication. Methods: We recruited 30 patients who were treated with laparoscopic surgery for the management of gynecologic disease. All study participants underwent abdominal compression to evacuate the CO₂ associated with their pneumoperitoneum. Postoperatively, the subjects’ pain intensity was measured via the visual analogue scale at 12, 24, and 48 hours. Results: The patients’ mean postoperative visual analogue scale pain scores were the highest during the initial 12 hours (1.93), and thereafter, steadily declined at 24 hours (0.73) and 48 hours (0.70) (P = .045). Furthermore, toxicity was reasonable, with only 20% of subjects who reported grade ≤2 nausea and vomiting. Conclusion: Abdominal compression is a relatively safe procedure that appears to sufficently evacuate residual CO₂, thereby reducing the severity of laparoscopic surgery induced shoulder pain.