Intraperitoneal Gas Drain to Reduce Postsurgical Shoulder Tip Pain in Gynecological Laparoscopy

Mohamed Zaki, Radwa Mansour; Mahmoud, Mohamed Taha Ismail; Abdel-Hafeez, Mohamed Abdel Hameed; Abdelghafour, Kholoud Khaled Saady

doi:10.21608/egyfs.2025.409773

Intraperitoneal Gas Drain to Reduce Postsurgical Shoulder Tip Pain in Gynecological Laparoscopy

Document Type : Original Article

Authors

Radwa Mansour Mohamed Zaki ¹^{, 2}
Mohamed Taha Ismail Mahmoud ¹^{, 3}
Mohamed Abdel Hameed Abdel-Hafeez ¹^{, 3}
Kholoud Khaled Saady Abdelghafour ¹^{, 4}

¹ Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University

² Assistant Professor of Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University

³ Professor of Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University

⁴ M.B.B.Ch - Faculty of Medicine – Alexandria University (2013). Master degree holder, Obstetrics and Gynecology Department, Faculty of Medicine, Ain Shams University.

10.21608/egyfs.2025.409773

Abstract

Background : Operative gynecologic laparoscopy has become the preferred method for treating benign gyne-cologic diseases due to its minimally invasive nature and faster recovery compared to laparotomy. However, post-laparoscopic shoulder pain (PLSP) is a common complaint following laparoscopic surgeries, affecting pa-tients' satisfaction and recovery. Various methods have been proposed to alleviate PLSP, but consensus on their effectiveness remains elusive.
Aim of the Work : This randomized controlled clinical trial aims to investigate the effect of gas drainage by in-traperitoneal drain on shoulder pain in women after lapa-roscopic surgery in comparison to no drain use.
Patients and Methods: A randomized controlled clini-cal trial involving 120 female patients undergoing laparo-scopic surgery was conducted to investigate the effect of intraperitoneal drainage on postoperative shoulder pain. The patients were divided into two groups: the study group (n=60) with intraperitoneal drain placement, and the control group (n=60) with routine technique and no drain use. Visual Analog Scale (VAS) scores were used to assess shoulder and abdominal pain at different postoper-ative time points.
Results: The study demonstrated that intraperitoneal drainage signiﬁcantly reduced postoperative shoulder pain in the ﬁrst 12 hours after surgery compared to the control group (p < 0.001 at 3 and 6 hours, p = 0.038 at 12 hours). However, no signiﬁcant difference in shoulder pain was observed between the two groups at 24 hours post-surgery (p = 0.451). The need for postoperative an-algesia was also lower in the drainage group (p < 0.001). These ﬁndings align with previous studies suggesting the efﬁcacy of drainage in reducing shoulder pain after lapa-roscopic surgery.
Conclusion: This study demonstrates the effectiveness of intraperitoneal drainage in reducing post-laparoscopic shoulder pain during the ﬁrst 24 hours af-ter surgery, consequently reducing the need for postoperative analgesics. These ﬁndings support the outcomes of previous investiga-tions, indicating that drain placement may be a valuable strategy to alleviate postoperative shoulder pain in women undergoing gyneco-logic laparoscopy.

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