Components of pain assessment after laparoscopic donor nephrectomy

Background Pain after laparoscopic surgery can be divided into three components: incisional or superficial wound pain, deep intra‐abdominal pain and referred shoulder pain. Better understanding and adequate assessment of post‐operative pain may be an important clue to the optimisation of recovery af...

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Bibliographic Details
Published in:Acta anaesthesiologica Scandinavica 2014-02, Vol.58 (2), p.219-222
Main Authors: ERGÜN, M., BERKERS, A. W., VAN DER JAGT, M. F., LANGENHUIJSEN, J. F., VAN ÖZDEMIR-BRUNSCHOT, D., VAN DER VLIET, J. A., D'ANCONA, F. C., WARLÉ, M. C.
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Pain - diagnosis
Abdominal Pain - etiology
Adult
Analysis of Variance
Female
Humans
Laparoscopy - adverse effects
Living Donors
Male
Middle Aged
Nephrectomy - adverse effects
Pain
Pain Measurement - methods
Pain, Postoperative - diagnosis
Pain, Postoperative - drug therapy
Postoperative Nausea and Vomiting - diagnosis
Postoperative Nausea and Vomiting - therapy
Prospective Studies
Shoulder Pain - diagnosis
Shoulder Pain - etiology
Surgery
Wound healing
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Summary:Background Pain after laparoscopic surgery can be divided into three components: incisional or superficial wound pain, deep intra‐abdominal pain and referred shoulder pain. Better understanding and adequate assessment of post‐operative pain may be an important clue to the optimisation of recovery after laparoscopic surgery. Therefore, we performed a components of pain assessment after laparoscopic donor nephrectomy. Methods Twenty patients who underwent a laparoscopic donor nephrectomy were included in this prospective study. Pain was subdivided into three components: superficial wound pain, deep intra‐abdominal pain and referred shoulder pain, and for each component a numeric rating scale (from 0 to 10) was obtained at 1, 24 and 48 h after surgery. Results Repeated measurements analysis of variance showed that during the first 48 h after surgery, the superficial wound and deep intra‐abdominal pain components were significantly higher as compared with the referred shoulder pain component. Although the deep intra‐abdominal pain component was slightly higher as compared with superficial wound pain, this difference was not significant (P = 0.097). Further assessment of superficial wound pain showed that the Pfannenstiel incision was the most significant determinant of this component of pain (P = 0.004), whereas deep intra‐abdominal pain was significantly higher at the ipsilateral side of the abdomen (P = 0.015). Discussion The components of pain assessment revealed that pain related to the Pfannenstiel incision and the deep intra‐abdominal pain component are the most important determinants of pain after laparoscopic donor nephrectomy. Further improvement of the management of post‐operative pain should focus on these components of pain.
ISSN:0001-5172
1399-6576
DOI:10.1111/aas.12236