Research progress on post-laparoscopic shoulder pain after gynecologic surgery

Shoulder pain after gynecological laparoscopic surgery is increasingly being regarded as a serious clinical problem. The main risk factors are excessively high CO₂ pressure during pneumoperitoneum, a very rapid CO₂ insufflation rate, and excessive residual CO₂ under the diaphragm. The mechanisms underlying the development of shoulder pain include mechanical stimulation, chemical stimulation, and the relationship with the intraoperative body position. On the basis of these risk factors and mechanisms, preventive measures can be implemented from three perspectives: surgery, nursing, and medication. In terms of surgical interventions, prevention involves limiting the pneumoperitoneum pressure and CO₂ insufflation rate and removing as much residual CO₂ gas as possible at the end of the surgery. From the nursing viewpoint, diverse interventions are implemented from multiple perspectives throughout the perioperative period. Additionally, preventive measures involving medications are being studied. This article reviewed the clinical characteristics, mechanisms, risk factors, and preventive measures for shoulder pain after laparoscopic gynecological surgery, with the aim of providing a reference for effective prevention strategies.