laparoscopic postoperative shoulder pain
Conditions
Interventions
Pulmonary Recruitment Maneuver combined with controlled hyperventilation group:PETCO2 was maintained at 30-34 by adjusting tidal volume, respiratory rate and inspiratory/expiratory ratio immediately a
Pulmonary Recruitment Maneuver group: After the end of laparoscopic surgery, lung recruitment maneuvers were performed 6 times (APL valve pressure was 40cm H20) for 5 seconds each time.
controlled hyperventilation group:PETCO2 was maintained at 30-34 by adjusting tidal volume, respiratory rate and inspiratory/expiratory ratio immediately after intubation.
control group:conventional passive exhaust method was used to expel residual CO2 (gentle pressure on the abdomen) + conventional mechanical ventilation to maintain PETCO2 at 35-45.
Sponsors
Affiliated Hospital of Xuzhou Medical University
Eligibility
Sex/Gender
Female
Age
18 Years to 65 Years
Inclusion criteria
Inclusion criteria: 1. The elective patients with gynecological surgery; 2.ASA grade ?-?; 3.18-65 years old; 4.BMI 18-30kg/?.
Exclusion criteria
Exclusion criteria: 1. Combined with chronic diseases such as scapulohumeral periarthritis and cervical spondylosis; 2. Preoperative have nausea and vomiting; 3. History of chest and shoulder surgery; 4. Pregnancy; 5. Decompensated heart disease (heart failure, myocardial infarction, severe arrhythmia); 6. Severe respiratory disease (severe obstructive or restrictive lung disease, respiratory failure, pneumothorax or emphysema); 7. Severe liver dysfunction (serum total bilirubin 2 mg/dl or higher); 8. Severe renal dysfunction (glomerular filtration rate < 60ml/ (min·1.73m2); 9. Had cognitive dysfunction before surgery and could not cooperate to complete the visit; 10. Recent use of non-steroidal analgesics; 11. The central nervous system disease; 12. Previous cerebral infarction.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| incidence of shoulder ache and VAS score; | — |
Secondary
| Measure | Time frame |
|---|---|
| Duration of postoperative shoulder soreness;Abdominal pain score (incision pain score and visceral pain score);Recovery of 48 h of 15 quality rating scale score (QoR - 15);Nausea and vomiting;The first postoperative exhaust time;Pulmonary complications (, pleural effusion, atelectasis, pneumothorax, etc.);Other complications (subcutaneous emphysema, etc.);Duration of anesthesia;Duration of pneumoperitoneum;Intraoperative consumption of remifentanil;Intraoperative consumption of sufentanil;Intraoperative infusion quantity;Intraoperative urinary volume;The end of the lung function (before pneumoperitoneum, pneumoperitoneum dynamic lung compliance);Consumption of remedial analgesics within 24 hours;Intraoperative hemodynamic changes in tidal volume, the airway peak pressure, breath at the end of the co2 partial pressure (PETCO2), intraoperative pneumoperitoneum pressure;The pH after and before pneumoperitoneum pneumoperitoneum, PaCO2, PaO2; | — |
Countries
China
Contacts
Public ContactGuanglei Wang
Affiliated Hospital of Xuzhou Medical University
Outcome results
None listed