Randomised clinical trial of the influence of pulmonary recruitment manoeuvre on reducing shoulder pain after laparoscopy

Shoulder pain after laparoscopy is common and its probable mechanism is residual CO2 gas after surgery. The aim of this study was to examine the effect of pulmonary recruitment manoeuvre which means pulmonary inflation with positive pressure of 40 cm H2O to remove gas and reduction of shoulder pain after gynaecological laparoscopic surgery. A double-blind clinical trial on 146 patients for minor gynaecological laparoscopy was performed from May 2008 to February 2009. Patients were randomly assigned into two groups of control and intervention (cases). The intervention was five manual inflations of the lungs with positive pressure ventilation of 40 cmH2O at the end of surgery, while the last one was held for 5 s. In the controls, CO2 was removed by the traditional passive deflation of abdominal cavity. Shoulder pain intensity was assessed at 4, 12, 24 and 48 h after the surgery using a visual analogue scale (VAS).The background variables; characteristics of operation and analgesic use were recorded. Statist...