Post-operative gas pains

Specialties Pediatric

Published

What are the best ways to relieve post-operative gas pains from laparoscopic surgeries and open abdominal surgeries? Some of our kiddos even complain of pain in the neck/shoulders where the gas has escaped. The physiology behind this still confuses me. Aside from frequent ambulation and pain medication, what can be done for these pains?

Specializes in SICU.

*guilty* of telling patients that the gas is moving toward their shoulders :( thanks for educating me re: phrenic nerve innervation! I never really thought about the anatomical impossibility of the former statement, I heard a surgeon telling a patient that and it stuck....

1) ambulation

2) mylicon

3) pain medication

4) warm drinks and other bowel care

5) hot pad to site of gas pains (usually shoulder or abdomen)

6) increase fluid intake

7) repositioning

In my experience on a busy surgical floor, heat make a huge different in relieving post op gas pain both in the abdomen and the shoulders. A warm blanket or compress around the shoulders makes a huge difference. As far as ambulation goes after surgery, I was under the impression that gas in the abdomen stimulates nerves that causes pain to radiate into the shoulders, especially the right shoulder. Ambulation helps to dislodge the gas from the nerve to relieve the pain, and also help stimulate the bowels so patients begin passing flatus that relieves any distension they experience.

I've found that having the patient drink Sprite (not 7-up) and frequently change positions on the stretcher helps

The pains in the shoulders are from the CO2 pressing on the diaphragm. Walking may actually make it worse. I've been an ambulatory surgery nurse for 29 years. We tell our patients the best way to relieve the pain is to lay flat. This helps the air to settle lower and stop it from pressing on the diaphragm. Time is the cure, the body reabsorbs the air in 24-48 hours. The patients needs to pace themselves until that time, laying flat when the pain gets bad.

Laughter! If you can find a way to make the patient laugh (funny YouTube videos, a comedy movie or TV show, etc) this truly is the best medicine. The diaphragmatic movement during laughter helps to dislodge bubbles and alleviate the shoulder/neck pain. Heat packs over the site also works but not as effectively as laughing. Use a good pillow splint to have the patient use on the abdomen while laughing.

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