Shoulder-type Pain Formation After Spinal Anesthesia and the Effect of Non-invasive Method on Pain Reduction


Türkiye Klinikleri Sağlık Bilimleri Dergisi, vol.6, no.2, pp.249-256, 2021 (Peer-Reviewed Journal) identifier


Objective: The effect of maternal up-head position on post-operative shoulder type pain (STP) during cesarean performed with spinal anesthesia and we planned it as a randomized controlled experimental study to evaluate the effectiveness of non-pharmacological methods in treatment. Material and Methods: Four hundred primiparous pregnant women who would undergo cesarean surgery with spinal anesthesia in the obstetrics service of a Private Nisa Hospital in İstanbul between February and August 2019 were included in the study. The participants were divided into two groups as head up position (n=200) and horizontal position (n=200) by simple random method. Dry hot application (n1=50 experimental group) and non-steroidal antiinflammatory drug (NSAID) gel application (n2=50 control group) were performed to 100 patients who developed STP in the post-operative period. Pain assessment before and after the procedure was performed with Visual Analog Scale (VAS). Results: When the groups are examined according to the maternal position, it was found that the incidence of STP in the horizontal position (31.5%) was higher than the head up 400 position (18.5%) (p<0.03). STP was 76% in the right arm, 6% in the left arm, and 18% in both arms (p<0.001). It was found that women with local dry hot application to shoulder pain had lower VAS 2 pain scores (1.62±1.44) than the group with NSAI gel application (2.32±1.64) (p<0.05). Conclusion: When STP developed after cesarean section was examined according to the maternal position during surgery; the pain was found to be less in the head up 400 position than in the horizontal position. Local dry hot application was found to be more effective in reducing pain in the acute period compared to NSAID gel application in patients with STP after surgery.