Abstract
Background
Some evidence suggests that females have a lower pain threshold and a lower tolerance to painful stimuli. This study investigated gender differences in postoperative pain after laparoscopic cholecystectomy (LC) on the basis of visual analog pain scale (VAS) scores and the clinical course.
Methods
The 100 patients in this study (46 males and 54 females) underwent LC for cholecystolithiasis or gallbladder polyps without intraoperative complications. An 8-mm Penrose drain was retained for 42 h below the liver bed. All the patients were hospitalized for 4 days after LC, and the pain reported by patients, the time course of changes in the highest body temperature, the leukocyte count, and the C-reactive protein level were studied comparatively for the male and female patients.
Results
The VAS scores were significantly higher for the female patients than for the male patients at 24 h (62.7 ± 24.6 vs 47.0 ± 23.3; p = 0.0015) and at 48 h (39.2 ± 24.3 vs 28.3 ± 19.1; p = 0.0137) after LC. The female patients used analgesics more frequently and had significantly higher body temperatures than the male patients on day 1 (37.2 ± 0.6 vs 36.9 ± 0.4; p = 0.0037) and day 2 (36.9 ± 0.6 vs 36.6 ± 0.4; p = 0.0037) after surgery.
Conclusions
Early postoperative pain after LC was more severe in female patients, and patients with high VAS scores tended to use analgesics more frequently.
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References
Ainslie WG, Catton JA, Davides D, Dexter S, Gibson J, Larvin M, McMahon MJ, Moore M, Smith S, Vezakis A (2003) Micropuncture cholecystectomy vs conventional laparoscopic cholecystectomy: a randomized controlled trial. Surg Endosc 17: 766–772
Briese E, Cabanac M (1991) Stress hyperthermia: physiological arguments that it is a fever. Physiol Behav 49: 1153–1157
Cepeda MS, Carr DB (2003) Women experience more pain and require more morphine than men to achieve a similar degree of analgesia. Anesth Analg 97: 1464–1468
Edwards R, Augustson E, Fillingim R (2003) Differential relationships between anxiety and treatment-associated pain reduction among male and female chronic pain patients. Clin J Pain 19: 208–216
Fillingim RB, Maixner W, Kincaid S, Silva S (1998) Sex differences in temporal summation but not sensory-discriminative processing of thermal pain. Pain 75: 121–127
Jensen R, Rasmussen BK, Pedersen B, Lous I, Olesen J (1992) Cephalic muscle tenderness and pressure pain threshold in a general population. Pain 48: 197–203
Kroin JS, Buvanendran A, Nagalla SK, Tuman KJ (2003) Postoperative pain and analgesic responses are similar in male and female Sprague–Dawley rats. Can J Anaesth 50: 904–908
Logan DE, Rose JB (2004) Gender differences in postoperative pain and patient controlled analgesia use among adolescent surgical patients. Pain 109: 481–487
Mauderli AP, Vierck CJ Jr, Cannon RL, Rodrigues A, Shen C (2003) Relationships between skin temperature and temporal summation of heat and cold pain. J Neurophysiol 90: 100–109
Perrakis E, Vezakis A, Velimezis G, Savanis G, Deverakis S, Antoniades J, Sagkana E (2003) Randomized comparison between different insufflation pressures for laparoscopic cholecystectomy. Surg Laparosc Endosc Percutan Tech 13: 245–249
Pitman DL, Natelson BH, Ottenweller JE, McCarty R, Pritzel T, Tapp WN (1995) Effects of exposure to stressors of varying predictability on adrenal function in rats. Behav Neurosci 109: 767–776
Riley JL III, Robinson ME, Wise EA, Myers CD, Fillingim RB (1998) Sex differences in the perception of noxious experimental stimuli: a meta-analysis Pain 74: 181–187
Rosseland LA, Stubhaug A (2004) Gender is a confounding factor in pain trials: women report more pain than men after arthroscopic surgery. Pain 112: 248–253
Saito K, Packianathan S, Longo LD (1997) Free radical-induced elevation of ornithine decarboxylase activity in developing rat brain slices. Brain Res 25: 232–238
Sarlani E, Grace EG, Reynolds MA, Greenspan JD (2004) Sex differences in temporal summation of pain and aftersensations following repetitive noxious mechanical stimulation. Pain 109: 115–123
Sarlani E, Greenspan JD (2002) Gender differences in temporal summation of mechanically evoked pain. Pain 97: 163–169
Sarli L, Costi R, Sansebastiano G, Trivelli M, Roncoroni L (2000) Prospective randomized trial of low-pressure pneumoperitoneum for reduction of shoulder-tip pain following laparoscopy. Br J Surg 87: 1161–1165
Swank DJ, Swank-Bordewijk SC, Hop WC, van Erp WF, Janssen IM, Bonjer HJ, Jeekel J (2003) Laparoscopic adhesiolysis in patients with chronic abdominal pain: a blinded randomized controlled multi-centre trial. Lancet: 1247–1251
Uchiyama K, Onishi H, Tani M, Kinoshita H, Kawai M, Ueno M, Yamaue H (2003) Long-term prognosis after treatment of patients with choledocholithiasis. Ann Surg 238: 97–102
Uchiyama K, Onishi H, Tani M, Kinoshita H, Ueno M, Yamaue H (2004) Timing of laparoscopic cholecystectomy for acute cholecystitis with cholecystolithiasis. Hepatogastroenterology 51: 346–348
Uchiyama K, Takifuji K, Tani M, Onishi H, Yamaue H (2002) Effectiveness of the clinical pathway to decrease length of stay and cost for laparoscopic surgery. Surg Endosc 16: 1594–1597
Vezakis A, Davides D, Gibson JS, Moore MR, Shah H, Larvin M, McMahon MJ (1999) Randomized comparison between low-pressure laparoscopic cholecystectomy and gasless laparoscopic cholecystectomy. Surg Endosc 13: 890–893
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Uchiyama, K., Kawai, M., Tani, M. et al. Gender differences in postoperative pain after laparoscopic cholecystectomy. Surg Endosc 20, 448–451 (2006). https://doi.org/10.1007/s00464-005-0406-0
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DOI: https://doi.org/10.1007/s00464-005-0406-0