Gender differences in postoperative pain after laparoscopic cholecystectomy.
BACKGROUND
Some evidence suggests that females have a lower pain threshold and a lower tolerance to painful stimuli. This study investigated gender differences in postoperative pain after laparoscopic cholecystectomy (LC) on the basis of visual analog pain scale (VAS) scores and the clinical course.


METHODS
The 100 patients in this study (46 males and 54 females) underwent LC for cholecystolithiasis or gallbladder polyps without intraoperative complications. An 8-mm Penrose drain was retained for 42 h below the liver bed. All the patients were hospitalized for 4 days after LC, and the pain reported by patients, the time course of changes in the highest body temperature, the leukocyte count, and the C-reactive protein level were studied comparatively for the male and female patients.


RESULTS
The VAS scores were significantly higher for the female patients than for the male patients at 24 h (62.7 +/- 24.6 vs 47.0 +/- 23.3; p = 0.0015) and at 48 h (39.2 +/- 24.3 vs 28.3 +/- 19.1; p = 0.0137) after LC. The female patients used analgesics more frequently and had significantly higher body temperatures than the male patients on day 1 (37.2 +/- 0.6 vs 36.9 +/- 0.4; p = 0.0037) and day 2 (36.9 +/- 0.6 vs 36.6 +/- 0.4; p = 0.0037) after surgery.


CONCLUSIONS
Early postoperative pain after LC was more severe in female patients, and patients with high VAS scores tended to use analgesics more frequently.
Uchiyama
K
K
Second Department of Surgery, Wakayama Medical University, School of Medicine, 811-1 Kimiidera, Wakayama 641-8510, Japan.
Kawai
M
M
Tani
M
M
Ueno
M
M
Hama
T
T
Yamaue
H
H
D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D017081:Cholecystectomy, Laparoscopic; D041761:Cholecystolithiasis / Q000601:surgery; D005260:Female; D005705:Gallbladder Diseases / Q000601:surgery; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D017288:Pain Threshold; D010149:Postoperative Pain / Q000453:epidemiology*; D011127:Polyps / Q000601:surgery; D012737:Sex Factors
D002097:C-Reactive Protein