Volume 30, Issue 3 (Avicenna Journal of Clinical Medicine-Autumn 2023)
Avicenna J Clin Med 2023, 30(3): 143-148 |
Back to browse issues page
Download citation:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
BibTeX | RIS | EndNote | Medlars | ProCite | Reference Manager | RefWorks
Send citation to:
Jafarkhani A, Imani B, Ghasemi S, Karkhanei B, Najafi Vosough R. Effect of Postoperative Trendelenburg Positioning in Reducing Shoulder Pain after Laparoscopic Cholecystectomy. Avicenna J Clin Med 2023; 30 (3) :143-148
URL: http://sjh.umsha.ac.ir/article-1-2807-en.html
URL: http://sjh.umsha.ac.ir/article-1-2807-en.html
1- Student Research Committee, Hamadan University of Medical Sciences, Hamadan, Iran
2- Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran ,behzadiman@yahoo.com
3- Department of Anesthesia, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
4- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
2- Department of Operating Room, School of Paramedicine, Hamadan University of Medical Sciences, Hamadan, Iran ,
3- Department of Anesthesia, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
4- Research Center for Health Sciences, Hamadan University of Medical Sciences, Hamadan, Iran
Abstract: (2537 Views)
Background and Objective: Shoulder pain is one of the most common complaints of patients after laparoscopic cholecystectomy, which seems to be closely related to the residual volume of carbon dioxide gas used during surgery. Therefore, this study was conducted with the aim of investigating the effect of Trendelenburg positioning after surgery in reducing shoulder pain in patients.
Materials and Methods: This study was conducted as a randomized clinical trial in 58 patients who were eligible for laparoscopic cholecystectomy. Patients were enrolled in the study by simple random sampling and randomly assigned to supine (control) and Trendelenburg (intervention) positions. After complete awakening in the recovery room, the patients in the intervention group were placed in the Trendelenburg position (30 degrees), while the patients in the control group were placed in the supine position for 30 minutes. The level of pain was measured 6, 12, 24and 48 hours after completion of the procedure using the NRS scale. Data analysis was performed using SPSS version 24 software.
Results: The results of this study show that there is a significant difference between the pain intensity 6, 12, 24and 48 hours after the end of the intervention between the two intervention and control groups (P >0.05). The pain in the intervention group is therefore lower than in the control group.
Conclusion: As a simpleeffective, and inexpensive technique, the Trendelenburg position can reduce shoulder pain in patients undergoing laparoscopic cholecystectomy
Materials and Methods: This study was conducted as a randomized clinical trial in 58 patients who were eligible for laparoscopic cholecystectomy. Patients were enrolled in the study by simple random sampling and randomly assigned to supine (control) and Trendelenburg (intervention) positions. After complete awakening in the recovery room, the patients in the intervention group were placed in the Trendelenburg position (30 degrees), while the patients in the control group were placed in the supine position for 30 minutes. The level of pain was measured 6, 12, 24and 48 hours after completion of the procedure using the NRS scale. Data analysis was performed using SPSS version 24 software.
Results: The results of this study show that there is a significant difference between the pain intensity 6, 12, 24and 48 hours after the end of the intervention between the two intervention and control groups (P >0.05). The pain in the intervention group is therefore lower than in the control group.
Conclusion: As a simpleeffective, and inexpensive technique, the Trendelenburg position can reduce shoulder pain in patients undergoing laparoscopic cholecystectomy
Type of Study: Original |
Subject:
Anesthesia
Extended Abstract [HTML 22 KB] (145 Download)
References
1. Dorostan N, Paziar F, Mirrokni M. Evaluation of Relationship between complications of cholecystitis and gender based on findings during laparoscopic cholecystectomy in educational hospitals of Ahvaz.[in persian]. Sci Med J. 2011;10 (2): 215-19.
2. Unalp-Arida A, Ruhl CE. The burden of gallstone disease in the United States population. medRxiv. 2022:2022-07. DOI: 10.1101/2022.07.08.22277386
3. Brunicardi F, Andersen D, Billiar T, Dunn D, Hunter J, Matthews J, Pollock R. Schwartz's principles of surgery,10e. McGraw-hill. 2014:1034-1099.
4. Goel A, Gupta S, Bhagat TS, Garg P. Comparative analysis of hemodynamic changes and shoulder tip pain under standard pressure versus low-pressure pneumoperitoneum in laparoscopic cholecystectomy. Eurasian J Hepatogastroenterol. 2019;9(1):5-8. PMID: 31988859 DOI: 10.5005/jp-journals-10018-1287
5. Vecchio R, MacFayden BV, Palazzo F. History of laparoscopic surgery. Panminerva Med. 2000;42(1):87-90. PMID: 11019611
6. Novitsky YW, Kercher KW, Czerniach DR, Kaban GK, Khera S, Gallagher-Dorval KA, et al. Advantages of mini-laparoscopic vs conventional laparoscopic cholecystectomy: results of a prospective randomized trial. Arch Surg. 2005;140(12):1178-83. PMID: 16365239 DOI: 10.1001/archsurg.140.12.1178
7. Hosseinzadeh F, Nasiri E, Behroozi T. Investigating the effects of drainage by hemovac drain on shoulder pain after female laparoscopic surgery and comparison with deep breathing technique: a randomized clinical trial study. Surg Endosc. 2020;34(12):5439-5446. PMID: 31932939 DOI: 10.1007/s00464-019-07339-z
8. Zeeni C, Chamsy D, Khalil A, Abu Musa A, Al Hassanieh M, Shebbo F, Nassif J. Effect of postoperative Trendelenburg position on shoulder pain after gynecological laparoscopic procedures: a randomized clinical trial. BMC Anesthesiol. 2020;20(1):27. PMID: 31996139 DOI: 10.1186/s12871-020-0946-9
9. Garteiz-Martínez D, Rodríguez-Ayala E, Weber-Sánchez A, Bravo-Torreblanca C, Carbó-Romano R. Pulmonary recruitment can reduce residual pneumoperitoneum and shoulder pain in conventional laparoscopic procedures: results of a randomized controlled trial. Surg Endosc. 2021;35(8):4143-4152. PMID: 32804268 DOI: 10.1007/s00464-020-07881-1
10. Aydemir Ö, Aslan FE, Karabacak Ü, Akdaş Ö. The Effect of Exaggerated Lithotomy Position on Shoulder Pain after Laparoscopic Cholecystectomy. Pain Manag Nurs. 2018;19(6):663-670. PMID: 29934129 DOI: 10.1016/j.pmn.2018.04.012
11. Riedel HH, Semm K. The post-laparoscopic pain syndrome (author's syndrome). [Article in German].Geburtshilfe Frauenheilkd. 1980;40(7):635-43. PMID: 6448764 DOI: 10.1055/s-2008-1037224
12. Jackson SA, Laurence AS, Hill JC. Does post-laparoscopy pain relate to residual carbon dioxide? .Anaesthesia. 1996;51(5):485-7. PMID: 8694166 DOI: 10.1111/j.1365-2044.1996.tb07798.x
13. Kojima Y, Yokota S, Ina H. Shoulder pain after gynaecological laparoscopy caused by arm abduction. Eur J Anaesthesiol. 2004;21(7):578-9. PMID: 15318475 DOI:10.1017/s0265021504267126
14. Lepner U, Goroshina J, Samarütel J. Postoperative pain relief after laparoscopic cholecystectomy: a randomised prospective double-blind clinical trial. Scand J Surg. 2003;92(2):121-4. PMID: 12841551.
15. Nyerges A. Pain Mechanisms in Laparoscopic Surgery. Semin Laparosc Surg. 1994;1(4):215-8. PMID: 10401061 DOI: 10.1053/SLAS00100215
16. Deng X, Li H, Wan Y, Lin X. Pulmonary recruitment maneuver reduces the intensity of post-laparoscopic shoulder pain: a systematic review and meta-analysis. BMC Anesthesiol. 2023;23(1):155. PMID: 37142975 DOI: 10.1186/s12871-023-02107-y
17. Imani B, Nejati H, Sepidkar A, Talebi-Ghane E. The Effect of Low-Pressure Pneumoperitoneum with Active Evacuation on the Severity of Shoulder Pain in Patients Undergoing Laparoscopic Cholecystectomy. J Adv Med Biomed Res. 2023;31(146):221
18. Demir Y. Non-pharmacological therapies in pain management. Pain management-Current issues and opinions. IntechOpen; 2012.
19. Kiyak H, Yilmaz G, Ay N. Semi-Fowler positioning in addition to the pulmonary recruitment manoeuvre reduces shoulder pain following gynaecologic laparoscopic surgery. Wideochir Inne Tech Maloinwazyjne. 2019;14(4): 567-74. PMID: 31908704 DOI: 10.5114/wiitm.2019.84384
20. Thong IS, Jensen MP, Miró J, Tan G. The validity of pain intensity measures: what do the NRS, VAS, VRS, and FPS-R measure?.Scand J Pain. 2018;18(1):99-107. PMID: 29794282 DOI: 10.1515/sjpain-2018-0012.
21. Coelho JCU, Dalledone GO, Schiel W, Berbardin JP, Claus CMP, Matias JEF, Freitas ACT. Does male gender increase the risk of laparoscopic cholecystectomy? Arq Bras Cir Dig.2019;32(2): e1438. PMID: 31460598 DOI: 10.1590/0102-672020190001e1438
22. Farda W, Tani MK, Manning RG, Fahmi MS, Barai N. Laparoscopic cholecystectomy: review of 1430 cases in Cure International Hospital, Kabul, Afghanistan. BMC Surg. 2021;21(1):344. PMID: 34530783 DOI: 10.1186/s12893-021-01342-9
Send email to the article author
| Rights and permissions | |
 |
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
Articles Copyright © The Author(s).
Owned by Hamadan University of Medical Sciences
Published by UMSHA Press
Journal Tel: +988138380924
Publisher Tel:+988138380548
Website: http://sjh.umsha.ac.ir
Email: s_ journal[at]umsha.ac.ir
