سندرم درد شانه پس از اعمال جراحی لاپاراسکوپی زنان: مکانیسم و روش‌های پیشگیری: مقاله مروری

نوع مقاله : مروری

نویسندگان

1 استادیار گروه بیهوشی و مراقبت‌های ویژه، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران.

2 استادیار گروه بیهوشی و مراقبت‌های ویژه، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 دستیار تخصصصی گروه بیماری‌های عفونی و گرمسیری، مجتمع بیمارستانی امام خمینی، دانشکده پزشکی، دانشگاه علوم پزشکی تهران، تهران، ایران. گروه بیماری‌های عفونی و گرمسیری، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران.

4 گروه بیهوشی و مراقبت‌های ویژه، دانشکده پزشکی، دانشگاه علوم پزشکی زاهدان، زاهدان، ایران. دستیار تخصصی گروه بیهوشی و مراقبت‌های ویژه، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

چکیده

مقدمه: درک بهتر مکانیسم و/یا پاتوفیزیولوژی سندرم درد شانه پس از اعمال جراحی لاپاراسکوپیک زنان منجر به افزایش تعداد کارآزمایی‌های بالینی جهت پیشگیری از این عارضه می‌شود؛ لذا مطالعه حاضر با هدف تعریف، مکانیسم و روش‌های پیشگیری از سندرم درد شانه پس از جراحی‌های لاپاراسکوپیک زنان انجام شد.
روش‌کار: در این مطالعه مروری روایتی، جهت یافتن مقالات مرتبط با سندرم درد شانه پس از اعمال جراحی لاپاراسکوپیک زنان، مطالعات منتشر شده از سال 2000 به بعد شامل مطالعات کارآزمایی بالینی، مشاهده‌ای، توصیفی و همبستگی در پایگاه­ های الکترونیکی PubMed، Scopus، EMBASE، PEDro، Google Scholar، CINAHL، SID و Magiran با کلیدواژه­ های سندرم درد شانه، درد شانه، جراحی، لاپاراسکوپی، زنان، جراحی، پس از جراحی و لاپاراسکوپی زنان مورد جستجو قرار گرفتند.
یافته ­ها: مکانیسم ­های اصلی جستجو شده شامل: مکانیسم درد، درد ناشی از برش زخم جراحی، علل سندرم درد شانه پس از اعمال جراحی لاپاراسکوپیک حیطه زنان، استفاده از یک گاز دمنده جایگزین برای کاهش سندرم درد شانه، استفاده از پنوموپریتونوم با فشار کم در کاهش سندرم درد شانه، لاپاراسکوپی بدون گاز و دفع فعال گاز برای کاهش سندرم درد شانه، استفاده از CO2 گرم شده یا گرم و مرطوب شده در کاهش سندرم درد شانه، استفاده از بی‌حسی داخل صفاقی زیر دیافراگماتیک یا بی‌حسی داخل صفاقی موضعی در کاهش درد نوک شانه و استفاده از مانور ریکورتمان ریوی در کاهش سندرم درد شانه بودند.
نتیجه ­گیری: سندرم درد شانه در جراحی‌های لاپاراسکوپیک زنان می‌تواند با اقدامات پیشگیرانه همچون استفاده از گاز مرطوب و گرم، تجویز داخل صفاقی ضددردهای موضعی و مانور ریکورتمان ریوی به‌حداقل برسد.

کلیدواژه‌ها

عنوان مقاله [English]

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

نویسندگان [English]

  • Jamshid Ordoni Avval 1
  • Mohammadreza Moshari 2
  • Mastaneh Dahi 2
  • Seyed Mohammad Nasirodin Tabatabaei 1
  • Alireza Rahat-Dahmardeh 1
  • Niyoosha Masoumzadeh 3
  • Mohammad Gharehbeglou 4
1 Assistant Professor, Department of Anesthesiology and critical Care Medicine, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
2 Assistant Professor, Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Resident, Department of Infectious and Tropical Diseases, Imam Khomeini Hospital, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Department of Infectious and Tropical Diseases, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran.
4 Department of Anesthesiology and critical Care Medicine, Faculty of Medicine, Zahedan University of Medical Sciences, Zahedan, Iran. Resident, Department of Anesthesiology and Critical Care Medicine, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
چکیده [English]

Introduction: 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.
Methods: 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.
Results: 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.
Conclusion: 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.

کلیدواژه‌ها [English]

  • Gynecology
  • Laparoscopy
  • Shoulder Pain Syndrome

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مجله زنان، مامایی و نازایی ایران
دوره 25، شماره 12
اسفند 1401
صفحه 102-113

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