The Effect of Exaggerated Lithotomy Position on Shoulder Pain after Laparoscopic Cholecystectomy

Abstract

Background: The exaggerated lithotomy position with the expertise of nurses can be successful solution for the patients who have the postoperative shoulder pain after laparoscopic cholecystectomy. Aims: This study aimed to determine the effect of applying an exaggerated lithotomy positions to patients who had laparoscopic cholecystectomy to relieve shoulder pain. The study was conducted on nonrandomized groups and made as a semiexperimental study with a pretest/post-test control group design. Design, Settings, and Subjects/Participants: The study was conducted on 102 patients who had elective laparoscopic cholecystectomy and agreed to participate in this study after they met the inclusion-exclusion criteria in the general surgery clinic of a training and research hospital in Istanbul between December 12, 2012, and June 30, 2013. Methods: The pain levels (10 minutes before and after positioning) and peripheral oxygen saturation (SPO<inf>2</inf>) levels (1 minute, 5 minutes, and 10 minutes before and after positioning—total 6 times) of the patients were measured using a visual analog scale and pulse oximetry, respectively. The pain levels and the analgesic (pethidine hydrochloride and diclofenac sodium) usage of the patients in both the experimental and the control group were compared. Results: The exaggerated lithotomy position appreciably lowered the shoulder pain of the patients in the experimental group (t = 12.663, p =.000 <.001). It also increased peripheral saturation levels of the patients more rapidly compared with those in the control group receiving analgesics (t = 17.693, p =.000 <.005). In addition, it decreased the need to use additional analgesics and opioids (t = 2.14, p =.037). Conclusions: In this study the exaggerated lithotomy position was found to be fast and effective for relieving shoulder pain after laparoscopic cholecystectomy, decreased the need to use additional analgesics and opioids, and, in conjunction with pain control, also contributed to improvements in respiratory functions. © 2020 Elsevier B.V., All rights reserved.