BACKGROUND: Laparoscopic surgery has many advantages compared with conventional methods and may allow a significant reduction in postoperative pain and analgesic consumption. Nevertheless, some patients still experience significant pain. Therefore, many clinicians have tried various methods to reduce of postoperative pain. We investigated degrees of postoperative pain and the incidences of shoulder pain versus the different methods of gas removal after laparoscopic surgery.

METHODS: Sixty ASA class I or II patients were included in this study. In Group A (Control group, n = 20), residual carbon dioxide was removed by the classic method without a drain tube. In Group B (Suction group, n = 20), residual carbon dioxide was removed using a suction device aggressively without a drain tube. In Group C (Drain group, n = 20), residual carbon dioxide was removed by the classic method with a drain tube. The intensities of abdominal and shoulder pain were assessed 1, 6, 24 and 48 hours after surgery using a visual analog scale (VAS) and a verbal rating scale (VRS). We also assessed the mean hospital stay for the three groups.

RESULTS: The abdominal pain scores (VAS and VRS) at 1 hour after surgery and the incidence of shoulder pain, epigastria pain and flank pain were significantly higher in Group A than in the other groups for 1hour after surgery (P < 0.05). Mean hospital stay was significantly longer for group C.

CONCLUSIONS: After laparoscopic surgery, the active removal of residual carbon dioxide may be a simple and safe method that significantly reduces postoperative shoulder and abdominal pain.