Pain Characteristics after Total Laparoscopic Hysterectomy

Area of Science:

• Gynecology
• Surgical Pain Management
• Minimally Invasive Surgery

Background:

• Total laparoscopic hysterectomy (TLH) is a common procedure with varied postoperative pain patterns.
• Detailed evaluation of pain characteristics after TLH is lacking.

Purpose of the Study:

• To investigate the types, intensity over time, and characteristics of postoperative pain within 72 hours after TLH.

Main Methods:

• Prospective observational study including 50 female patients who underwent TLH.
• Pain assessed using a 100 mm visual analog scale at multiple time points (baseline to 72 hours).
• Pain locations included overall, abdominal (visceral, incisional), shoulder, and perineal pain, assessed at rest and motion.

Main Results:

• Abdominal and incisional pain were most intense on the day of surgery, decreasing thereafter.
• Shoulder pain increased postoperatively, peaking at 24 hours in 90% of patients.
• Preoperative exercise habit was associated with a higher pain threshold for shoulder pain; right shoulder pain was more severe.

Conclusions:

• Postoperative pain following TLH exhibits distinct patterns compared to other laparoscopic procedures.
• Shoulder pain is a significant issue peaking at 24 hours and influenced by exercise habits and analgesic requests.
• Perineal pain was prevalent and, in some cases, more severe than abdominal pain.