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https://hdl.handle.net/2440/10237
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Type: | Journal article |
Title: | Pain after laparoscopy |
Author: | Mouton, W. Bessell, J. Otten, K. Maddern, G. |
Citation: | Surgical Endoscopy: surgical and interventional techniques, 1999; 13(5):445-448 |
Publisher: | SPRINGER |
Issue Date: | 1999 |
ISSN: | 0930-2794 1432-2218 |
Abstract: | <h4>Background</h4>In the context of the much-heralded advantages of laparoscopic surgery, it can be easy to overlook postlaparoscopy pain as a serious problem, yet as many as 80% of patients will require opioid analgesia. It generally is accepted that pain after laparoscopy is multifactorial, and the surgeon is in a unique position to influence many of the putative causes by relatively minor changes in technique.<h4>Methods</h4>This article reviews the relevant literature concerning the topic of pain after laparoscopy.<h4>Results</h4>The following factors, in varying degrees, have been implicated in postlaparoscopy pain: distension-induced neuropraxia of the phrenic nerves, acid intraperitoneal milieu during the operation, residual intra-abdominal gas after laparoscopy, humidity of the insufflated gas, volume of the insufflated gas, wound size, presence of drains, anesthetic drugs and their postoperation effects, and sociocultural and individual factors.<h4>Conclusions</h4>On the basis of the factors implicated in postlaparoscopy pain, the following recommendations can be made in an attempt to reduce such pain: emphathically consider each patients' unique sociocultural and individual pain experience; inject port sites with local anesthesia at the start of the operation; keep intra-abdominal pressure during pneumoperitoneum below 15 mmHg, avoiding pressure peaks and prolonged insufflation; use humidified gas at body temperature if available; use nonsteroidal anti-inflammatory drugs at the time of induction; attempt to evacuate all intraperitoneal gas at the end of the operation; and use drains only when required, rather than as a routine. |
Keywords: | Humans Pain, Postoperative Laparoscopy |
DOI: | 10.1007/s004649901011 |
Published version: | http://dx.doi.org/10.1007/s004649901011 |
Appears in Collections: | Aurora harvest 2 Surgery publications |
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