Shoulder pain syndrome after laparoscopy: epidemiology, pathogenesis, prevention methods

Shapovalova E.A., Basos A.S., Shkarupa I.A., Glushchenko Zh.V., Тereshin S.M., Babina U.F., Savina A.A., Shiryaeva A.V.

1) Saint Petersburg State University Hospital, Saint Petersburg, Russia, Saint Petersburg, Russia; 2) Dzhanelidze Saint Petersburg Research Institute of Emergency Сare, Saint Petersburg, Russia; 3) Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia, Saint Petersburg, Russia
Laparoscopy is considered the gold standard for the surgical treatment of most pelvic diseases. Along with this, laparoscopic interventions are accompanied by the appearance of a specific postlaparoscopic shoulder pain (PLSP). During the first two days after surgery some patients can experience a severe pain which limits their mobilization. There is a global trend towards the introduction of protocols for enhanced recovery after surgery (ERAS) aimed at reducing the stress associated with the surgical intervention and the rapid return of patients to normal life. This article describes the epidemiology of postlaparoscopic shoulder pain. Its pathogenesis and the most common theories of its origin are reviewed. The results of the studies devoted to the methods of reducing postoperative pain syndrome in accordance with the suggested theories are presented in the article. There is a description of the effect of changing the gas for the pneumoperitoneum and reducing its pressure level, instillation of saline solution into the abdominal cavity, forced gas removal, as well as local use of anesthetics.
Conclusion: To date, this issue has not been sufficiently covered in the national literature, and the available data from foreign studies are contradictory. It is necessary to conduct the research on the frequency of postlaparoscopic pain syndrome and factors affecting its severity, as well as the search for effective and safe methods for its reduction.

Authors’ contributions: Shapovalova E.A. – developing the concept of the study, analysis and interpretation of the obtained data, writing and editing the text, approval of the final version of the article; Basos A.S., Shkarupa I.A., Glushchenko Zh.V. – developing the concept of the study, editing the text, approval of the final version of the article; Tereshin S.M., Babina U.F., Savina A.A., Shiryaeva A.V. – data collection and analysis, writing the text.
Conflicts of interest: The authors declare no possible conflicts of interest.
Funding: The study was conducted without sponsorship.
For citation: Shapovalova E.A., Basos A.S., Shkarupa I.A., Glushchenko Zh.V., Тereshin S.M., Babina U.F., Savina A.A., Shiryaeva A.V. Shoulder pain syndrome after laparoscopy: epidemiology, pathogenesis, prevention methods.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2023; (9): 44-51 (in Russian)


shoulder pain after laparoscopy
postoperative pain syndrome


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Received 13.06.2023

Accepted 20.06.2023

About the Authors

Ekaterina A. Shapovalova, PhD, obstetrician-gynecologist, Saint Petersburg State University Hospital, 199034, Russia, Saint Petersburg, Fontanka Embankment, 154,
Alexander S. Basos, PhD, obstetrician-gynecologist, Saint Petersburg State University Hospital, 199034, Russia, Saint Petersburg, Fontanka Embankment, 154,
Irina A. Shkarupa, Deputy Director for Medical Affairs (Gynecology), obstetrician-gynecologist, Saint Petersburg State University Hospital, 199034, Russia, Saint Petersburg, Fontanka Embankment, 154.
Zhanna V. Glushchenko, Head of the Department of Gynecology, obstetrician-gynecologist, Saint Petersburg State University Hospital, 199034, Russia, Saint Petersburg, Fontanka Embankment, 154,
Sergey М. Тereshin, obstetrician-gynecologist, Saint Petersburg State University Hospital, 199034, Russia, Saint Petersburg, Fontanka Embankment, 154,
Ulyana F. Babina, Resident of the Department of Obstetrics and Gynecology, Dzhanelidze Saint Petersburg Research Institute of Emergency Care,
192242, Russia, Saint Petersburg, Budapest str., 3, lit. A,
Anna A. Savina, Resident of the Department of Obstetrics, Gynecology and Reproductology, Saint Petersburg State University, 199034, Russia, Saint Petersburg,
University Embankment, 7-9,
Anna V. Shiryaeva, Resident of the Department of Obstetrics, Gynecology and Reproductology, Pavlov First Saint Petersburg State Medical University,
Ministry of Health of Russia, 197022, Russia, Saint Petersburg, Leo Tolstoy str., 6-8,
Corresponding author: Ekaterina A. Shapovalova,

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