Can post-laparoscopy pain be effectively reduced by the use of a peritoneal gas drain?

Abstract

The aim of the study was to investigate whether the use of an intraperitoneal gas drain for 4 h postlaparoscopy reduces the incidence and severity of postoperative pain for up to 48 h postoperatively. A randomized controlled trial was carried out on a population of 82 women undergoing laparoscopy for sterilization, elective subfertility diagnostic procedure, or IVF and GIFT procedures, In the 'gas drain' group one end of a 12 gauge (3 mm diameter) suction catheter was inserted via the subumbilical cannula into the peritoneal cavity with the other end taped to the abdominal wall at the end of the laparoscopy, and in the control group no drain was left in the peritoneal cavity. The incidence of immediate postoperative pain was reduced by 20-24% in the 43 women who had a gas drain inserted, compared with the 39 women in the control group. In keeping with this, there was a significant reduction in the number of women who experienced moderate or severe pain in the gas drain group compared with the control group (odds ratio 0.38, 95% CI 0.15-0.94). No difference was found in the use of immediate postoperative analgesia. At 48 h women in the gas drain group continued to show a significant reduction in the severity of postoperative pain experienced. It is concluded that the use of an intraperitoneal gas drain for 4 h postlaparoscopy significantly reduces the incidence and severity of pain experienced by women postoperatively both in the immediate recovery phase and up to 48 h after the operation. The use of such a simple drain can be recommended for routine clinical practice.