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Association between postoperative shoulder pain and left-side laparoscopic urologic surgery: a single-center retrospective cohort study

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Abstract

Purpose

Postoperative shoulder pain is a common problem after laparoscopic surgery. This study aimed to investigate the association between operative side and postoperative shoulder pain following urologic laparoscopic surgery performed in the lateral recumbent position.

Methods

This was a retrospective cohort study conducted at a single tertiary care center. A total of 506 patients who underwent urologic laparoscopic surgery (including adrenalectomy, radical nephrectomy, partial nephrectomy, and pyeloplasty) between January 2010 and December 2019 were included. Patients who underwent total nephroureterectomy or resection of other organs were excluded. The primary outcome was the incidence of postoperative shoulder pain. A multivariable logistic regression analysis investigated the association between the operative side and postoperative shoulder pain.

Results

Among the 506 included patients, there were an equal number of surgeries on the left and right sides. Eighty-eight patients had postoperative shoulder pain. The incidence of postoperative shoulder pain in the left-side group was significantly higher than that in the right-side group (21.3% [54/253] versus 13.4% [34/253], crude odds ratio = 1.75, 95% confidence interval [CI] 1.07–2.89). After adjustment for potential confounders (age, sex, body mass index, operation duration, operative technique, epidural block, peripheral nerve block, American Society of Anesthesiologists physical status classification, and intraoperative rocuronium dose), the left operative side was found to be associated with postoperative shoulder pain (adjusted odds ratio = 1.89, 95% CI 1.15–3.09).

Conclusion

The left operative side is associated with an increased incidence of postoperative shoulder pain after urologic laparoscopic surgery performed in the lateral recumbent position.

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Data availability

The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.

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Authors and Affiliations

  1. Department of Anesthesiology and Critical Care Medicine, Yokohama City University Graduate School of Medicine, 3–9 Fukuura, Kanazawa-Ku, Yokohama, Kanagawa, 236-0004, Japan

    Hiroko Fujimoto, Yusuke Nagamine & Takahisa Goto

Authors
  1. Hiroko Fujimoto
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  2. Yusuke Nagamine
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  3. Takahisa Goto
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Contributions

Conceptualization: Hiroko Fujimoto, Yusuke Nagamine. Investigation: Hiroko Fujimoto. Methodology: Hiroko Fujimoto, Yusuke Nagamine. Project administration: Hiroko Fujimoto, Yusuke Nagamine. Supervision: Takahisa Goto. Visualization: Hiroko Fujimoto. Writing—original draft: Hiroko Fujimoto. Writing—review and editing: Yusuke Nagamine, Takahisa Goto. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hiroko Fujimoto.

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Fujimoto, H., Nagamine, Y. & Goto, T. Association between postoperative shoulder pain and left-side laparoscopic urologic surgery: a single-center retrospective cohort study. J Anesth (2024). https://doi.org/10.1007/s00540-024-03341-5

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  • DOI: https://doi.org/10.1007/s00540-024-03341-5

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