title: Active gas aspiration versus simple gas evacuation to reduce shoulder pain after diagnostic laparoscopy: A randomized controlled trial.
abstract: OBJECTIVE
  To evaluate the effectiveness of active gas aspiration to reduce postoperative shoulder pain in infertile women undergoing day-case diagnostic laparoscopy.
  
  
  METHODS
  Seventy four infertile women undergoing diagnostic laparoscopy during July 2013 to February 2014 were randomized to an active gas aspiration or simple gas evacuation (control) group at the end of the surgery. Postoperative shoulder and wound pain were assessed using a visual analog scale at 6, 12 and 24 h after surgery. Consumption of rescue analgesics and adverse events were recorded.
  
  
  RESULTS
  There were 37 patients in each group. The shoulder pain scores of the active gas aspiration group showed lower pain intensity than the simple gas evacuation group, with statistically significant results at at all time points. There was no significant difference in surgical wound pain. The proportion of patients who required postoperative rescue analgesics was lower in the study than in control group (43.2% vs. 67.6%, P = 0.035). There was no significant difference in adverse events until 24 h after surgery.
  
  
  CONCLUSIONS
  Active gas aspiration provided a significantly superior effect on postoperative shoulder pain relief after diagnostic laparoscopy when compared to simple gas evacuation, without any adverse events.
authors.affiliation: Department of Obstetrics and Gynecology, Chulalongkorn University.
authors.forename: Nujaree
authors.initials: N
authors.lastname: Leelasuwattanakul
authors.affiliation: Department of Obstetrics and Gynecology, Chulalongkorn University.
authors.forename: Suvit
authors.initials: S
authors.lastname: Bunyavehchevin
authors.affiliation: Department of Anesthesiology, Faculty of Medicine, Chulalongkorn University.
authors.forename: Pin
authors.initials: P
authors.lastname: Sriprachittichai
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D007247:Infertility, Female; D010535:Laparoscopy / Q000009:adverse effects*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000517:prevention & control*; D020069:Shoulder Pain / Q000150:complications / Q000517:prevention & control*; D013396:Suction / Q000379:methods*
keywords: gas aspiration; infertility; laparoscopy; postoperative pain; shoulder pain