The so-called pain in modern medicine is a complex physical and psychological activity and one of the most common symptoms in clinical practice. It includes the pain sensation caused by noxious stimuli acting on the body, and the body's pain response to noxious stimuli. These pains include not only physical motor reactions, visceral plant reactions, but also strong emotional colors. Therefore, the impact of postoperative pain can be divided into two aspects: first, poor mood, that is, unhappy; second, physical reaction, mainly a series of changes brought about by adverse stress.
Once the surgical patient has postoperative pain, bystanders often do not understand the patient: such a small incision is too stingy. People with certain medical knowledge will also be thinking: "The pain of cutting the skin", ancient people have found that only the skin is the most painful; in addition, modern medical anatomy also proves that most of the pain nerves are distributed on the skin. Therefore, this kind of pain may only be experienced and understood by the patient. If we do not understand and encourage at this time, it will often cause psychological trauma to them. Failure to timely medical intervention will also affect postoperative recovery and even lead to serious perioperative accidents.
At first, doctors tested whether the pain was caused by sensitization of incision pain. Therefore, doctors even used local anesthetics to infiltrate analgesia layer by layer or install analgesic pumps on such small incisions. However, more and more studies have shown that pain after laparoscopic surgery is not dominated by incision pain. Most patients complain of pain under the diaphragm and shoulder, and sometimes the pain is quite obvious, and its degree and duration often exceed the wound pain.
In-depth studies have found that phrenic nerve traction during pneumoperitoneum formation may be the main cause of postoperative pain. The current consensus view is: In order to obtain sufficient operating space, most surgeons should form pneumoperitoneum during laparoscopic surgery. Although the exposure of the surgical field is sufficient, the stretching of the diaphragm by the force of the diaphragm exerted by the pneumoperitoneum and the resulting damage to the phrenic nerve may be related to postoperative pain; In addition, the phrenic nerve is very sensitive to traction, and 20% of the nerve traction will lead to occlusion of nerve vessels and ischemia, which may also be the main cause of pain.
In addition, factors such as the temperature and humidity of the gas filled in the abdominal cavity and residual gas in the abdominal cavity after the operation may also be the main causes of postoperative pain.
For these reasons, doctors also thought of many methods, such as phrenic nerve block, warming laparoscopic gas, and exhausting the gas in the abdominal cavity after the operation. If the patient has obvious pain, give appropriate doses of analgesics.
Therefore, when someone complains of pain after laparoscopic surgery, don't think it is squeamish, it may be true!
