Efficacy of ultrasound-guided right phrenic nerve block in preventing shoulder pain after total laparoscopic hysterectomy

Abstract

Objective To investigate the efficacy of ultrasound-guided right phrenic nerve block in preventing shoulder pain after total laparoscopic hysterectomy. Methods A total of 160 patients, aged 45-65, weighing 50-80 kg, of American Society of Anesthesiologists physical status Ⅰ or Ⅱ, scheduled for elective total laparoscopic hysterectomy, were divided into 2 groups (n = 80 each) using the random number table method: control group (group C) and right phrenic nerve block group (R group). The right phrenic nerve blockade was performed before induction of anesthesia, and 0.375% ropivacaine 6 ml was injected in R group.Tracheal intubation was used for total intravenous anesthesia in two groups.The severity of postoperative shoulder pain was assessed using visual analogue scale score.When visual analogue scale score≥4, ketorolac tromethamine 30 mg was given.The development of shoulder pain and consumption of analgesics within 72 h after operation were recorded. Results Compared with group C, the incidence of postoperative shoulder pain and consumption of analgesics were significantly decreased in group R (P< 0.05). Conclusion Ultrasound-guided right phrenic nerve block can prevent shoulder pain after total laparoscopic hysterectomy. Key words: Phrenic nerve; Nerve block; Laparoscopy; Hysterectomy; Shoulder pain