Pain medication requirements after sacropexy and combination interventions.
OBJECTIVE
Laparoscopic surgery is associated with reduced morbidity, and postoperative pain is reduced. The aim of this study was to assess postoperative pain intensity, analgesic requirements, and the influence of cofactors after laparoscopic sacral colpopexy.


METHODS
The study assessed 287 patients treated with laparoscopic sacropexy for genital prolapse with a Pelvic Organ Prolapse Quantification grade>1. Patients were asked to evaluate their pain postoperatively using a 4-point verbal pain rating scale. In addition, medical records were analyzed regarding the requirement for analgesic medication.


RESULTS
Patients distinguished between abdominal pain and shoulder pain after laparoscopy. Abdominal pain reached maximum severity on day 1 and showed a good response to nonsteroidal antiphlogistics, whereas shoulder pain was rarely found (6.27%). Of the patients, 38% required no pain treatment or required 1 dose at most. The need for pain medication reached its climax on day 1 and decreased during the 5 following days. Non-opioid analgesics provided a sufficient therapeutic effect.


CONCLUSIONS
Laparoscopic sacropexy is associated with a moderate degree of postoperative pain. Non-opioid analgesics should be preferred as first-line therapy. The typical shoulder-tip pain showed only a low prevalence in our study group. From our point of view, the low rate of shoulder-tip pain corresponded with the low intra-abdominal carbon dioxide pressure.
Dormagen Hospital, Dormagen, Germany.
Guenter Karl
GK
Noé
University of Witten Herdecke, Witten, Germany.
Sven
S
Schiermeier
University of Witten Herdecke, Witten, Germany.
Wolfgang
W
Hatzmann
Dormagen Hospital, Dormagen, Germany.
Stefan
S
Soltész
Dormagen Hospital, Dormagen, Germany.
Carolin
C
Spüntrup
Dormagen Hospital, Dormagen, Germany.
Michael
M
Anapolski
D015746:Abdominal Pain / Q000188:drug therapy* / Q000209:etiology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D059408:Pain Management / Q000379:methods*; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D056887:Pelvic Organ Prolapse / Q000601:surgery*; D016896:Treatment Outcome
D000700:Analgesics
Laparoscopic sacropexy; Laparoscopic surgery; Pain medication; Pain treatment; Postoperative pain; Prolapse surgery; Shoulder-tip pain; Vault prolapse