Suprascapular nerve block or a piroxicam patch for shoulder tip pain after day case laparoscopic surgery

Hong, Jeong Yeon; Lee, I. H.

doi:10.1017/s0265021503000395

Cited by 5 publications

(3 citation statements)

References 264 publications

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“… 27 , 28 In patients undergoing gynecological laparoscopic surgery, a prophylactic NSAID patch was effective for the relief of shoulder tip pain. 29 Recently, perioperative pregabalin also significantly reduced postoperative laparoscopic shoulder pain. 30 …”

Section: Discussionmentioning

confidence: 99%

Pain Characteristics after Total Laparoscopic Hysterectomy

Choi¹,

Kang²,

Song³

et al. 2016

Int. J. Med. Sci.

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Background. Total laparoscopic hysterectomy (TLH) causes various types of postoperative pain, and the pain pattern has not been evaluated in detail to date. This prospective observational study investigated the types of postoperative pain, intensity in the course of time, and pain characteristics during the first postoperative 72 hr after TLH.Methods. Sixty four female patients undergoing TLH were enrolled, which finally 50 patients were included for the data analyses. The locations of pain included overall pain, abdominal visceral and incisional pains, shoulder pain, and perineal pain. Assessments were made at rest and in motion, and pain level was scored with the use of the 100 mm visual analog scale. The pain was assessed at baseline, and at postoperative 30 min, 1 hr, 3 hr, 6 hr, 24 hr, 48 hr, and 72 hr.Results. Overall, visceral, and incisional pains were most intense on the day of operation and then decreased following surgery. In contrast, shoulder pain gradually increased, peaking at postoperative 24 hr. Shoulder pain developed in 90% of all patients (44/50). It was not more aggravated in motion than at rest, in comparison with other pains, and right shoulder pain was more severe than left shoulder pain (p=0.006). In addition, the preoperative exercise habit of patients increased the threshold of shoulder pain. Most patients (46/50) had perineal pain, which was more severe than abdominal pain in approximately 30% of patients (17/50).Conclusion. Pain after TLH showed considerably different duration, severity, and characteristics, compared with other laparoscopic procedures. Shoulder pain was most intense at postoperative 24 hr, and the intensity was associated with the prior exercise habit of patients and the high level of analgesic request.

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Section: Discussionmentioning

confidence: 99%

Pain Characteristics after Total Laparoscopic Hysterectomy

Choi¹,

Kang²,

Song³

et al. 2016

Int. J. Med. Sci.

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“…In addition, a previous study reported that patients with laparoscopic gynaecological surgery were often accompanied with shoulder pain, which is considered a referred pain conducted by the phrenic (C3-5) and supraclavicular (C3-4) nerves. 29 Therefore, in this study, all patients were administered non-steroidal antiinflammatory drugs and opioids to effectively relieve the postoperative shoulder pain, which was also beneficial to the ERAS protocol. In previous studies, patients were often in a lateral decubitus position when performing the anterior QLB.…”

Section: Discussionmentioning

confidence: 99%

Ultrasound-guided anterior quadratus lumborum block at the L2 level for postsurgical analgesia in patients undergoing laparoscopic gynaecological surgery: a single-centre, randomised, double-blinded trial at a university-affiliated hospital in China

Huang,

Cai,

Yang

et al. 2023

BMJ Open

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ObjectiveThis study aimed to investigate the analgesic effect of an ultrasound-guided anterior quadratus lumborum block (QLB) at the L2 level on postoperative pain after laparoscopic gynaecological surgery.DesignProspective single-centre randomised double-blind trial.SettingUniversity-affiliated hospital.ParticipantsSixty patients aged between 18 and 65 years scheduled for laparoscopic gynaecological surgery.InterventionsBefore surgery, bilateral anterior QLB was performed with 20 mL of 0.375% ropivacaine injected on each side in the QLB group, whereas equal amount of saline was administered in the placebo group.Primary and secondary outcome measuresThe primary endpoint was the cumulative morphine dose in the first 24 hours, and the secondary endpoints were morphine consumption at each time interval, area under the curve (AUC) of the numeric rating scale (NRS) for pain, maximum pain intensity, incidence of moderate-to-severe pain (NRS>3), sedation score, adverse events, and time to home-readiness.ResultsCumulative morphine consumption in the first 24 hours after surgery was significantly lower in the QLB group than in the placebo group (mean difference, 14.2; 95% CI 6.3 to 22.1; p<0.001). The AUCs of NRS pain intensity scores, including visceral and incisional pain at rest and on movement, were significantly lower in the QLB group than in the placebo group (all p<0.001). The time to home-readiness was significantly shorter in the QLB group than in the placebo group (p<0.05).ConclusionUltrasound-guided anterior QLB at the L2 level significantly reduced morphine consumption and relieved visceral and incision pain intensity after laparoscopic gynaecological surgery, which was beneficial for enhanced recovery.Trial registration numberChinese Clinical Trial Registry (ChiCTR-IOR-17011960).

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“…For this purpose, warmed and humidified CO 2 insufflation, intraperitoneal local anesthetic injection, subdiaphragmatic intraperitoneal local anesthesia, oral pregabalin, piroxicam patch, and meridian acupressure therapy were used. [ 23 – 26 ] The present study may contribute to the studies on preventing SP in children since many of these studies were in adult population and data on children are quite rare.…”

Section: Discussionmentioning

confidence: 99%

Effects of Intraperitoneal Bupivacaine Injection in Laparoscopic Appendectomy in Children on Postoperative Pain: A Controlled Randomized Double Blinded Study

Ergün¹

2021

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: The aim of this study is to determine the effects of local anesthetics administered intraperitoneally in laparoscopic appendectomy. METHODS: Patients who underwent laparoscopic appendectomy due to acute appendicitis were enrolled in the study. The children were divided into two groups. Intraperitoneal bupivacaine injection to appendectomy site and subdiaphragmatic area was performed after resection of appendix and aspirastion of intraperitoneal reactive fluid in Group 1 while Group 2 did not receive this therapy. The children were questioned by a nurse at postoperative 1 st , 6 th , 12 th , and 24 th h. Pain scores (PS) (abdominal), abdominal wall incisional pain (IP), shoulder pain (SP), and first need for analgesics were recorded. RESULTS: One hundred and twenty children were enrolled to the study. There was no significant difference in PS values and IP values between the two groups (p>0.05). SP values at 12 th and 24 th h were significantly lower in Group 1 (p<0.05). There was a statistically significant reduce in analgesic need in Group 1 (p=0.007). CONCLUSION: Intraperitoneal bupivacaine instillation to surgery site and subdiaphragmatic area seems to reduce the SP post-operative and also reduce post-operative analgesic need. More meaningful results can be obtained with an increase in the number of patients.

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Suprascapular nerve block or a piroxicam patch for shoulder tip pain after day case laparoscopic surgery

Abstract: Prophylactic piroxicam patches are effective and safe for the relief of shoulder tip pain after laparoscopy. Bilateral suprascapular nerve block is not effective in this setting.

Cited by 5 publications

References 264 publications

Pain Characteristics after Total Laparoscopic Hysterectomy

Pain Characteristics after Total Laparoscopic Hysterectomy

Ultrasound-guided anterior quadratus lumborum block at the L2 level for postsurgical analgesia in patients undergoing laparoscopic gynaecological surgery: a single-centre, randomised, double-blinded trial at a university-affiliated hospital in China

Effects of Intraperitoneal Bupivacaine Injection in Laparoscopic Appendectomy in Children on Postoperative Pain: A Controlled Randomized Double Blinded Study

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