Effect of fluid instillation on postlaparoscopy pain.
One hundred thirty-seven patients participated in a randomized, double-blind study to determine what effect instillation of fluid at the conclusion of operative laparoscopy has on postoperative postural pain. The first phase examined pain intensity as related to closing pH, operative time and the surgeon. The second phase focused on the absence or presence of postural pain in the fluid and control groups. In phase 1, there was no significant relationship between pain and duration of surgery, closing pH or surgeon. In phase 2, 6 of 27 (22%) patients receiving postoperative fluid instillation experienced postural pain as compared to 19 of 25 (76%) in the control group (P < .001). Displacing the pneumoperitoneum by the instillation of 1-2 L of fluid at the conclusion of laparoscopy significantly decreased the frequency of subdiaphragmatic and shoulder pain on sitting or standing. This pain is probably produced by traction on the triangular or coronary ligaments of the liver due to loss of the suction effect by the diaphragm.
Perry
C P
CP
AMI Brookwood Women's Medical Center, Birmingham, Alabama 35209.
Tombrello
R
R
D000328:Adult; D004311:Double-Blind Method; D006801:Humans; D007274:Injections, Intraperitoneal; D007552:Isotonic Solutions / Q000008:administration & dosage*; D010535:Laparoscopy; D010149:Postoperative Pain / Q000628:therapy*; D011446:Prospective Studies; D000077331:Ringer's Solution; D012965:Sodium Chloride / Q000008:administration & dosage*; D016896:Treatment Outcome
D007552:Isotonic Solutions; D012965:Sodium Chloride; D000077331:Ringer's Solution