Effect of ultrasound-guided phrenic nerve block on shoulder pain after laparoscopic cholecystectomy—a prospective, randomized controlled trial View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-12-30

AUTHORS

Myung Sub Yi, Won Joong Kim, Min Kyoung Kim, Hyun Kang, Yong-Hee Park, Yong Hun Jung, Seung Eun Lee, Hwa Yong Shin

ABSTRACT

BackgroundPost-laparoscopic shoulder pain (PLSP) frequently follows a laparoscopic cholecystectomy. A proposed mechanism for PLSP is the irritation or injury of the phrenic nerve by the CO2 pneumoperitoneum during laparoscopic surgery. Here, we investigated whether a phrenic nerve block (PNB), performed under ultrasound guidance, could reduce the incidence and severity of PLSP after laparoscopic cholecystectomy.MethodSixty patients were randomized into two groups, with one group receiving PNB with 4 ml (30 mg) of 0.75% ropivacaine (group P, n = 28) and a control group (group C, n = 32). The existence and severity of PLSP were assessed for 2 days postoperatively. A pulmonary function test (PFT) and diaphragmatic excursion test were performed pre- and postoperatively.ResultsWith ultrasound guidance, all PNBs were performed successfully in group P. In group P, the overall incidence and severity of PLSP decreased significantly. There were no significant differences in incisional pain, visceral pain, and analgesic requirements between the groups. Right-side diaphragmatic excursion decreased significantly in group P at 1 h postoperatively. The PFT results and respiratory discomfort assessed by a modified Borg’s scale were not different significantly between the groups.ConclusionBased on these findings, ultrasound-guided PNB can prevent or reduce the PLSP without clinically significant respiratory discomfort. More... »

PAGES

3637-3645

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s00464-016-5398-4

DOI

http://dx.doi.org/10.1007/s00464-016-5398-4

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https://app.dimensions.ai/details/publication/pub.1009259942

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28039653


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43 Borg scale
44 CO2 pneumoperitoneum
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46 PFT results
47 PLSP
48 ResultsWith ultrasound guidance
49 Right-side diaphragmatic excursion
50 analgesic requirements
51 block
52 cholecystectomy
53 control group
54 days
55 diaphragmatic excursion
56 diaphragmatic excursion test
57 differences
58 discomfort
59 effect
60 excursion
61 excursion test
62 existence
63 findings
64 function tests
65 group
66 group P
67 group P.
68 guidance
69 incidence
70 incisional pain
71 injury
72 irritation
73 laparoscopic cholecystectomy
74 laparoscopic surgery
75 mechanism
76 nerve
77 nerve block
78 overall incidence
79 p.
80 pain
81 patients
82 phrenic nerve
83 phrenic nerve block
84 pneumoperitoneum
85 pulmonary function tests
86 requirements
87 respiratory discomfort
88 results
89 ropivacaine
90 scale
91 severity
92 severity of PLSP
93 shoulder pain
94 significant differences
95 significant respiratory discomfort
96 surgery
97 test
98 trials
99 ultrasound guidance
100 ultrasound-guided PNB
101 visceral pain
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