• M Ergün, A W Berkers, M F van der Jagt, J F Langenhuijsen, D van Özdemir-Brunschot, J A van der Vliet, F C D'Ancona, and M C Warlé.
• Department of Surgery, Division of Vascular and Transplant Surgery, Radboud University Nijmegen Medical Center, The Netherlands.
• Acta Anaesthesiol Scand. 2014 Feb 1;58(2):219-22.

BackgroundPain after laparoscopic surgery can be divided into three components: incisional or superficial wound pain, deep intra-abdominal pain and referred shoulder pain. Better understanding and adequate assessment of post-operative pain may be an important clue to the optimisation of recovery after laparoscopic surgery. Therefore, we performed a components of pain assessment after laparoscopic donor nephrectomy.MethodsTwenty patients who underwent a laparoscopic donor nephrectomy were included in this prospective study. Pain was subdivided into three components: superficial wound pain, deep intra-abdominal pain and referred shoulder pain, and for each component a numeric rating scale (from 0 to 10) was obtained at 1, 24 and 48 h after surgery.ResultsRepeated measurements analysis of variance showed that during the first 48 h after surgery, the superficial wound and deep intra-abdominal pain components were significantly higher as compared with the referred shoulder pain component. Although the deep intra-abdominal pain component was slightly higher as compared with superficial wound pain, this difference was not significant (P = 0.097). Further assessment of superficial wound pain showed that the Pfannenstiel incision was the most significant determinant of this component of pain (P = 0.004), whereas deep intra-abdominal pain was significantly higher at the ipsilateral side of the abdomen (P = 0.015).DiscussionThe components of pain assessment revealed that pain related to the Pfannenstiel incision and the deep intra-abdominal pain component are the most important determinants of pain after laparoscopic donor nephrectomy. Further improvement of the management of post-operative pain should focus on these components of pain.© 2013 The Acta Anaesthesiologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

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