婦人科腹腔鏡手術における術後の治療介入を要する肩痛出現頻度を減らす因子の検討

抄録

Objective: To evaluate whether decreased abdominal air pressure and continuous administration of muscle relaxants may help relieve severe postoperative shoulder pain.

Design: Retrospective cohort study.

Settings: Single-center general hospital.

Patients: A total of 158 patients who had undergone laparoscopic gynecological surgery were included in the study. Patients were devided into three groups based on the surgical conditions used as follows: standard pneumoperitoneum pressure (10 mmHg) without muscle relaxants, standard pneumoperitoneum pressure with muscle relaxants, and low pneumoperitoneum pressure (eight mmHg) with muscle relaxants.

Interventions: Reduction of pneumoperitoneum pressure and continuous administration of muscle relaxants.

Main outcome: There were no differences in patient characteristics or surgical procedures among the three groups. However, low pneumoperitoneum pressure decreased the frequency of severe postoperative shoulder pain when compared to the application of standard pneumoperitoneum pressure (p= 0.001; odds ratio = 0.28; 95% confidence interval= 0.13–0.61).

Results: Low pneumoperitoneum pressure decreased the frequency of severe postoperative shoulder pain compared to the use of standard pneumoperitoneum pressure.

Conclusion: Reduction of pneumoperitoneum pressure reduces the frequency of severe postoperative shoulder pain after laparoscopic gynecological surgery.