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J Am Assoc Gynecol Laparosc. 2003 May;10(2):210-4.

Effects of closed suction drainage in reducing pain after laparoscopic-assisted vaginal hysterectomy.

Author information

1
Department of Obstetrics and Gynecology, Chang Gung Memorial Hospital and Department of Biological Sciences, National Sun Yat-Sen University, Kaohsiung, Taiwan.

Abstract

STUDY OBJECTIVE:

To estimate whether closed suction drainage of the pelvis after laparoscopic-assisted vaginal hysterectomy (LAVH) reduces the frequency and intensity of shoulder-tip, abdominal, and back pain.

DESIGN:

Prospective, randomized study (Canadian Task Force classification 1).

SETTING:

Teaching medical center.

PATIENTS:

One hundred sixty-four women.

INTERVENTION:

LAVH.

MEASUREMENTS AND MAIN RESULTS:

For group 1 (80 women), closed suction (Jackson-Pratt) drains were inserted into the peritoneal cavity and cul-de-sac, whereas for group 2 (84), no drains were placed. Shoulder-tip, abdominal, and back pain were evaluated by visual analog scores (VAS) 3, 24, and 48 hours after surgery. The frequency of shoulder-tip pain was significantly lower in group 1 at 24 hours (23% vs 40%, p = 0.013) and 48 hours (9% vs 21%, p = 0.024; VAS scores at 24 hrs 2.2 +/- 1.1 vs 3.8 +/- 1.3, p = 0.010; VAS scores at 48 hours 1.5 +/- 1.0 vs 2.5 +/- 1.2, p = 0.018). At 48 hours fewer women in group 1 experienced abdominal pain (31% vs 50%, p = 0.039; VAS scores 2.0 +/- 1.1 vs 4.0 +/- 1.3, p = 0.007). No statistically significant differences in frequency and VAS scores for back pain were found at any time. The quantity of oral analgesics was greater for group 2 than for group 1 (12.4 +/- 1.6 vs 9.0 +/- 1.4, p <0.001). Economic evaluation of analgesic requirements and material costs for the two groups showed that simple analgesics were more cost-effective than closed suction drainage in the treatment of pain.

CONCLUSION:

Closed suction drains may reduce the frequency and intensity of shoulder-tip and abdominal pain and postoperative analgesia requirements after LAVH, but simple oral analgesics are more cost effective.

PMID:
12732774
DOI:
10.1016/s1074-3804(05)60301-5
[Indexed for MEDLINE]

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