Shoulder pain syndrome after laparoscopy: epidemiology, pathogenesis, prevention methods

Laparoscopy is considered the gold standard for the surgical treatment of most pelvic diseases. Along with this, laparoscopic interventions are accompanied by the appearance of a specific postlaparoscopic shoulder pain (PLSP). During the first two days after surgery some patients can experience a severe pain which limits their mobilization. There is a global trend towards the introduction of protocols for enhanced recovery after surgery (ERAS) aimed at reducing the stress associated with the surgical intervention and the rapid return of patients to normal life. This article describes the epidemiology of postlaparoscopic shoulder pain. Its pathogenesis and the most common theories of its origin are reviewed. The results of the studies devoted to the methods of reducing postoperative pain syndrome in accordance with the suggested theories are presented in the article. There is a description of the effect of changing the gas for the pneumoperitoneum and reducing its pressure level, instillation of saline solution into the abdominal cavity, forced gas removal, as well as local use of anesthetics.

Conclusion: To date, this issue has not been sufficiently covered in the national literature, and the available data from foreign studies are contradictory. It is necessary to conduct the research on the frequency of postlaparoscopic pain syndrome and factors affecting its severity, as well as the search for effective and safe methods for its reduction.