The Effect of Manual Maneuver on Shoulder Pain of Laparoscopic Gynecology Surgery, a Randomized Clinical Trial Study

Abstract

Background: Shoulder pain following gynecological laparoscopy is a common complication that requires treatment. Objectives: This study aimed to evaluate the effect of manual maneuvers on shoulder pain following laparoscopic surgery in women. Methods: This parallel clinical trial was conducted with 77 female laparoscopy candidates referred to Yas Hospital in Tehran in 2023. After the laparoscopic procedure, the intervention group had CO2 gas actively removed from the abdomen during a two-handed abdominal massage, while the control group received only traditional passive gas evacuation. The intensity of pain was assessed 6- and 24-hours post-operation using the Visual Analogue Scale (VAS), and the number of painkillers and anti-nausea medications used was recorded in each patient's chart. All data were entered into SPSS software and analyzed using appropriate statistical tests. Results: The average age of the women was 39.4 ± 10.1 years, and the average body mass index (BMI) was 27.5 ± 2.5 kg/m². No significant difference was observed between the two groups in these characteristics. Six hours after the operation, the pain intensity was 4.6 ± 0.86 in the intervention group and 6.2 ± 1.1 in the control group, with a significant reduction in the intervention group (P = 0.001). Twenty-four hours post-operation, pain intensity was 2.7 ± 0.79 in the intervention group and 4.2 ± 1.1 in the control group, again showing a significant decrease in the intervention group (P = 0.001). Additionally, the need for analgesics was significantly lower in the intervention group (P = 0.001). Conclusions: The results of this study indicate that manual abdominal massage following laparoscopic surgery can significantly reduce shoulder pain, decrease the need for analgesics, and enhance patient satisfaction.