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International Journal of Gynecology and Obstetrics Research
Manipulating gas deflation to reduce laparoscopic post-operative pain
Amira Mohammed Badawy
MD, Lecturer of Obstetrics and Gynaecology, Gynae-oncology Unit, Department of Obstetrics and Gynaecology, Faculty of Medicine, Alexandria University, Egypt.
Accepted 22 June, 2017
Citation: Badawy AM (2017). Manipulating gas deflation to reduce laparoscopic post-operative pain. International Journal of Gynecology and Obstetrics Research, 3(1): 024-030.
Copyright: © 2017 Badawy AM. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are cited.
Pneumoperitoneum is essential during laparoscopic surgeries. However, residual intra-abdominal gas was proved to be responsible for postoperative upper abdominal and shoulder-tip pain. The current study aimed to assess the safety and efficacy of active gas deflation at the end of gynaecologic laparoscopic surgeries, as a method to reduce post-operative gas-induced pain. The study included 40 cases, planned for operative laparoscopy for benign gynaecologic indications. Cases were randomly allocated to one of the 3 designed groups; Group-A (10 cases), where passive rapid gas deflation was done, group-B (15 cases), where passive slow gas deflation was done, and group-C (15 cases), where gas was rapidly and actively deflated. Postoperative pain was assessed by Visual Analogue Scale (VAS) at 1, 6, 24 hours and 7 days after operation. Postoperative analgesic requirements and frequency of nausea and vomiting were also recorded. The overall results showed that postoperative VAS was significantly less in group C. Total amount of analgesia needed in group C and B was significantly less compared to group A (p=0.0001). We concluded that active aspiration of residual gas at the end of gynaecologic laparoscopy significantly reduces postoperative pain. This simple clinical manoeuvre may also reduce postoperative nausea and vomiting.
Keywords: Gynaecologic laparoscopy, shoulder tip pain, gas deflation, gas aspiration, post laparoscopy pain.