Shoulder pain syndrome after gynecological laparoscopic surgery: Mechanisms and methods of prevention: A review study

A better understanding of the mechanism and / or pathophysiology of shoulder pain syndrome after laparoscopic gynecological surgery leads to an increase in the number of clinical trials to prevent this complication. Therefore, the present study was conducted with aim to define the mechanism and prevention methods of shoulder pain syndrome after laparoscopic gynecology surgeries.

In this narrative review study, to find the articles related to shoulder pain syndrome after laparoscopic gynecology surgeries, the published articles from 2000 including observational and clinical trials, descriptive and correlational studies were searched in the electronic databases of PubMed, Scopus, EMBASE, PEDro, Google Scholar, CINAHL , SID and Magiran with the keywords of shoulder pain syndrome, shoulder pain, surgery, laparoscopy, gynecology, postoperative and gynecology laparoscopy.

The main searched mechanisms included the pain mechanism, pain due to surgical incision, causes of shoulder pain syndrome after laparoscopic surgery in women, use of an alternative blowing gas to reduce shoulder pain syndrome, use of low pressure pneumoperitoneum to reduce the shoulder pain syndrome, gas-free laparoscopy and active gas excretion to reduce shoulder pain syndrome, use of heated or heated and humidified CO2 to reduce shoulder pain syndrome, use of sub-diaphragmatic intraperitoneal anesthesia or localized intraperitoneal anesthesia to reduce tip shoulder pain and use of pulmonary recurrence maneuvers in reducing shoulder pain syndrome.

Shoulder pain syndrome in laparoscopic gynecological surgeries can be minimized with preventive measures such as the use of hot and humid gas, intraperitoneal administration of local analgesics and pulmonary recovery maneuver.