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Effect of ultrasound-guided phrenic nerve block on shoulder pain after laparoscopic cholecystectomy—a prospective, randomized controlled trial

Title
Effect of ultrasound-guided phrenic nerve block on shoulder pain after laparoscopic cholecystectomy—a prospective, randomized controlled trial
Authors
Yi M.S.Kim W.J.Kim M.K.Kang H.Park Y.-H.Jung Y.H.Lee S.E.Shin H.Y.
Ewha Authors
김원중
Issue Date
2016
Journal Title
Surgical Endoscopy and Other Interventional Techniques
ISSN
0930-2794JCR Link
Citation
pp. 1 - 9
Keywords
CholecystectomyLaparoscopicNerve blockPhrenic nerveShoulder painUltrasonography
Publisher
Springer New York LLC
Indexed
SCI; SCIE; SCOPUS scopus
Abstract
Background: Post-laparoscopic shoulder pain (PLSP) frequently follows a laparoscopic cholecystectomy. A proposed mechanism for PLSP is the irritation or injury of the phrenic nerve by the CO2 pneumoperitoneum during laparoscopic surgery. Here, we investigated whether a phrenic nerve block (PNB), performed under ultrasound guidance, could reduce the incidence and severity of PLSP after laparoscopic cholecystectomy. Method: Sixty patients were randomized into two groups, with one group receiving PNB with 4 ml (30 mg) of 0.75% ropivacaine (group P, n = 28) and a control group (group C, n = 32). The existence and severity of PLSP were assessed for 2 days postoperatively. A pulmonary function test (PFT) and diaphragmatic excursion test were performed pre- and postoperatively. Results: With ultrasound guidance, all PNBs were performed successfully in group P. In group P, the overall incidence and severity of PLSP decreased significantly. There were no significant differences in incisional pain, visceral pain, and analgesic requirements between the groups. Right-side diaphragmatic excursion decreased significantly in group P at 1 h postoperatively. The PFT results and respiratory discomfort assessed by a modified Borg’s scale were not different significantly between the groups. Conclusion: Based on these findings, ultrasound-guided PNB can prevent or reduce the PLSP without clinically significant respiratory discomfort. © 2016 Springer Science+Business Media New York
DOI
10.1007/s00464-016-5398-4
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의료원 > 의료원 > Journal papers
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