The Effect of Hot Application on Shoulder Pain and Analgesic Use After Laparoscopic Upper Abdominal Surgery
试验速览
- 阶段
- 不适用
- 状态
- 已完成
- 入组人数
- 60
- 试验地点
- 1
- 主要终点
- change of pain
研究概览
简要总结
The aim of this study; To evaluate the effect of hot application on postlaparoscopic shoulder pain and analgesic use in patients undergoing upper laparoscopic surgery in general surgery.
详细描述
Among the advantages of laparoscopic surgery; smaller incisions, less postoperative pain, less need for analgesia, shorter hospital stay, earlier return to normal activities and lower morbidity. However, laparoscopic surgery is associated with postoperative shoulder pain, which is rarely seen in open surgeries. The precise mechanism of postlaparoscopic shoulder pain (PLOA) is unclear, but it is believed that the carbon dioxide remaining after laparoscopic surgery causes shoulder pain by causing irritation of the phrenic nerve. In some cases, PLOA may cause more discomfort to the patient than incisional pain.
Hot application is an effective method used to relieve pain. Hot application activates the gate control mechanism, stimulating tactile receptors, reducing ischemic pain with vasodilation, removing metabolic wastes, increasing the release of endorphins, eliminating muscle spasm, reducing effects such as pressure, stretching and hypoxia on nerve endings as a result of changes in the viscoelastic properties of tissues, raising the pain threshold, It reduces or relieves pain by sedating and creating relief in the patient.
Hot application is easy to use, inexpensive, requires no prior application, and has minimal adverse side effects when used correctly. Heat sources include a hot water heater, an electric heating pad, a warm blanket, and a warm bath or shower. In addition to being used as a pain reliever, heat is used to relieve chills or shivering, reduce joint stiffness, reduce muscle spasm, and increase connective tissue extensibility.
In the study of Mohamed et al., in which they examined the effect of hot application and early mobilization on shoulder pain, in the experimental group patients who received hot application; Postoperative shoulder pain was found to be significantly less than the control group at different evaluation times at 4 hours after surgery and at 6, 12 and 24 hours (p<0.001).
研究设计
- 研究类型
- Interventional
- 分配方式
- Randomized
- 干预模型
- Parallel
- 主要目的
- Supportive Care
- 盲法
- Single (Outcomes Assessor)
入排标准
- 年龄范围
- 18 Years 至 —（Adult, Older Adult）
- 性别
- All
- 接受健康志愿者
- 否
入选标准
- •Aged ≥18 years. Scheduled for elective laparoscopic upper abdominal surgery. No previous laparoscopic surgery. ASA physical status I-III. Able to understand and complete the study assessments. Provided written informed consent to participate in the study.
排除标准
- •Undergoing emergency surgery. Cognitive impairment preventing reliable pain self-report.
研究组 & 干预措施
control group
Participants allocated to the control group receive standardized routine postoperative care only. Post-laparoscopic shoulder pain intensity is assessed using the Visual Analogue Scale (VAS) at six predefined postoperative intervals: 0-2, 2-4, 4-8, 8-12, 12-18, and 18-24 hours. Pain intensity is assessed before the administration of any additional analgesic medication. Postoperative analgesic administration is monitored throughout the 24-hour observation period, including whether additional analgesia is administered and, when administered, whether the medication is classified as opioid or non-opioid.
Hot application
Participants allocated to the intervention group receive standardized routine postoperative care plus local heat therapy. Local heat therapy is initiated within the first postoperative hour using a hot-water bag covered with a protective sheath and maintained at a maximum temperature of 55°C. The hot-water bag is positioned beneath the shoulder and applied for 15-20 minutes. The intervention is repeated at 2-hour intervals during the first 24 postoperative hours or until complete resolution of shoulder pain, whichever occurs first. Skin integrity and patient tolerance are monitored before, during, and after each application. Post-laparoscopic shoulder pain intensity is assessed using the Visual Analogue Scale (VAS) at six predefined postoperative intervals: 0-2, 2-4, 4-8, 8-12, 12-18, and 18-24 hours. In the intervention group, pain intensity is assessed before each heat application and, in both groups, before administration of any additional analgesic medication. Postoperative analge
干预措施: Local heat therapy (Other)
结局指标
主要结局
change of pain
时间窗: During the first 24 postoperative hours (0-2, 2-4, 4-8, 8-12, 12-18, and 18-24 hours).
Post-laparoscopic shoulder pain intensity is assessed using the Visual Analogue Scale (VAS), consisting of a 10-cm horizontal line ranging from 0 ("no pain") to 10 ("worst imaginable pain"). Higher scores indicate greater pain intensity. Pain intensity is assessed at six predefined postoperative intervals: 0-2, 2-4, 4-8, 8-12, 12-18, and 18-24 hours.
analgesic consumption
时间窗: During the first 24 postoperative hours (0-2, 2-4, 4-8, 8-12, 12-18, and 18-24 hours).
Postoperative analgesic administration is recorded at each predefined assessment interval as whether additional analgesia is administered and, if administered, whether the analgesic is classified as opioid or non-opioid.
change of pain
时间窗: 24 hours
Numerical Pain Rating Scale (NRS) The form used by Williamson \& Hoggart (2005) to assess pain, patients will be asked to select a number from 0 to 10 that best describes their current pain. 0 means no pain and 10 means severe pain. It will be scored as no pain (0), mild pain (1-3), moderate (4-7) and severe pain (8-10).
analgesic consumption
时间窗: 24 hours
analgesic consumption form
次要结局
未报告次要终点
研究者
Derya Gezer
Assistant Professor
Cukurova University