News: Simple maneuver reduces postlaparoscopy shoulder pain

A simple pulmonary recruitment maneuver reduces residual abdominal carbon dioxide after laparoscopic surgery, thereby reducing shoulder pain, according to the results of a randomized controlled trial.

Researchers from California, Turkey, and Germany included in their study 116 women scheduled for elective gynecologic laparoscopic surgery. Approximately half of the women received the current standard of care with residual CO₂ removed by passive deflation of the abdominal cavity through the cannula (controls). The remaining women were placed in a Trendelenburg position (30°) at the end of surgery and received five manual inflations of their lung.

Postoperative pain scores were significantly higher in the control group than in the intervention group at 12, 24, and 36 hours after discharge. At 48 hours postdischarge, 83% of the control group reported shoulder pain versus 63% of the intervention group. In addition, the maneuver reduced positional pain by about 50% (from 63% to 31%; P<.05), and the incidence of postoperative nausea and vomiting by more than 50% (from 56.5% to 20.4%; P<.001).