婦人科腹腔鏡手術後の肩痛のリスク因子とプレガバリンの効果

Risk factors and effect of postoperative pregabalin on postoperative shoulder pain after laparoscopic gynecologic surgery

◆要約：婦人科腹腔鏡手術後の肩痛に対しプレガバリンを用いることで，有病率と要因，肩痛の軽減効果について後方視的に検討を行った．2017年1月から2018年12月の379例を対象とし，患者希望時にプレガバリンの頓服投与を行った．診療録よりプレガバリン服用の有無，肩痛変化の有無および患者の年齢，BMI，手術時間，出血量を抽出して解析に用いた．379症例中，プレガバリン投与を希望したのは35症例（9.2％）で，若年者，低BMI者に多かった．また，全例で肩痛の軽減が確認された．婦人科腹腔鏡手術後の肩痛は若年者，低BMI者がリスク因子となる可能性があり，プレガバリンの術後頓服投与は有効である可能性が示唆された．

　［Objective］This study aimed to examine the risk factors and effect of postoperative pregabalin administration in relieving postoperative shoulder pain among patients undergoing laparoscopic gynecologic surgery. ［Methods］We reviewed the medical records of 379 patients who had undergone laparoscopic gynecologic surgery between January 2017 and December 2018. During this period, pregabalin was administered to patients with complaints of shoulder pain despite the administration of analgesics, such as opioids and nonsteroidal anti-inflammatory drugs after the surgery. ［Results］A retrospective study was conducted. For statistical analysis, the patients were divided into two groups : patients who received pregabalin（n＝35, 9.2％）and those who did not（n＝344）. Patients administered pregabalin showed reduced shoulder pain. Although statistical analysis revealed no significant differences in the time of surgery and amount of blood loss, significant differences were observed in age and body mass index（BMI）. Therefore, these results suggest that postoperative shoulder pain after laparoscopic gynecologic surgery is a possible risk factor for people with lower BMI and young people. ［Conclusions］Postoperative administration of pregabalin effectively relieved shoulder pain after laparoscopic gynecologic surgery.