Shoulder tip pain during and after caesarean section: A narrative review

Shoulder tip pain (STP) is a common, yet under-recognised complication experienced during and after caesarean section (CS). Although typically mild in intensity and resolving spontaneously in most cases within 72 h, it can still be a source of significant discomfort for women undergoing CS awake under neuraxial anaesthesia. To comprehensively appraise the incidence, mechanism, and management options of STP, we performed a literature search on databases including PubMed, EMBASE, and the Cochrane Library. The included studies revealed several simple but potentially effective preventive strategies, such as placing the patients in reverse Trendelenburg position during surgery, and the use of surgical packing around the uterus prior to uterine entry. This review highlights the need for adequately powered randomised trials on this common issue. Our institution is currently designing a prospective trial to investigate the intraoperative incidence of STP, which may lead to further studies on the feasibility of various interventions in the Australian context.