title: The Use of Peritoneal Suction Drainage to Reduce Shoulder Pain Caused by Gynecological Laparoscopy.
abstract: OBJECTIVE
  To compare the outcomes of patients undergoing uncomplicated laparoscopic gynecologic procedures with and without drainage, and investigate the effects of drainage on postoperative shoulder pain, hospital stay and analgesic medications.
  
  
  METHODS
  In this randomized clinical trial, 92 patients undergoing uncomplicated laparoscopic gynecologic procedures at Pars Hospital, Tehran, Iran, between April 2012 and July 2014 entered the study. Patients were randomly divided into two groups: one group received a drain at the end of operation, whereas the second group didn't receive a drain. For patients closed with drainage, Hemovac plastic passive drains were inserted without negative pressure. Severity of the patients' postoperative shoulder pain was evaluated at rest using the 10-point visual analogue scale (VAS) at 12 h, 24 h, and 48 h after surgery.
  
  
  RESULTS
  There was no difference between the two groups regarding age, weight, height, BMI, the cause of surgery and the blood loss during the surgery. At 12 h and 24 h after surgery, the shoulder pain was statistically lower in the group with drainage (P < 0.001 for both). There was no statistically significant difference between mean VAS scores of the case and control group at 48 hours post-surgery (P = 0.806). A significantly higher postoperative demand for analgesics was observed in the control group (P < 0.001). There was no statistically significant difference between two groups regarding the length of hospital stay.
  
  
  CONCLUSIONS
  Our findings suggest that drainage may be useful to prevent postoperative shoulder pain among patients undergoing gynecological laparoscopic surgeries and decrease the need for pain medication. Further studies are recommended to assess the feasibility and cost effectiveness of using this method for reducing the postoperative shoulder pain.
authors.affiliation: Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Tehran, Iran.
authors.forename: Ameneh
authors.initials: A
authors.lastname: Haghgoo
authors.affiliation: Minimally Invasive Techniques Research Center in Women, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran. shahlachaichian@yahoo.com.
authors.forename: Shahla
authors.initials: S
authors.lastname: Chaichian
authors.affiliation: Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Tehran, Iran.
authors.forename: Mehran
authors.initials: M
authors.lastname: Ghahremani
authors.affiliation: Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Tehran, Iran.
authors.forename: Shahla
authors.initials: S
authors.lastname: Nooriardebili
authors.affiliation: Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Tehran, Iran.
authors.forename: Abdolrasool
authors.initials: A
authors.lastname: Akbaian
authors.affiliation: Pars Advanced and Minimally Invasive Manners Research Center, Pars Hospital, Tehran, Iran.
authors.forename: Bahram
authors.initials: B
authors.lastname: Moazzami
mesh_terms: D000328:Adult; D000700:Analgesics / Q000627:therapeutic use; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000009:adverse effects*; D006801:Humans; D007492:Iran; D010535:Laparoscopy / Q000009:adverse effects*; D007902:Length of Stay; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy / Q000517:prevention & control*; D020069:Shoulder Pain / Q000517:prevention & control*; D013396:Suction / Q000379:methods*; D013997:Time Factors; D055815:Young Adult
chemical_list: D000700:Analgesics