Post-operative gas pains

[Double-Helix]

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?

[nurseprnRN, BSN, RN]

Thank you. I think I mean the referred pain from the diaphragm nerve (Phrenic nerve, I think). But I did remember a patient from nursing school who has serious crepitus in his neck, but I remember now that he was post-op a lobectomy, so a different surgical area. I appreciate the insight here. It looks like ambulation, pain mediation and time is really the only solution.

Yep, he had an air leak from the injured lung (remember, surgery is just expensive trauma).

[kgroundw]

In one of my nursing textbooks, Lewis et al say to put the patient into Sims position ( on left side with the right knee flexed). It says that this helps the air pocket move away from the diaphragm... I wish I'd read this before I did a GI surgical rotation where everyone was s/p lap. I also remember that this was the worst part about the lap surgeries for the patients.

I suspect that walking might have made it worse in the short-run (after all, standing up straight would make the air pocket press right up against the diaphragm, right?), although perhaps it still helped in the long run?

[TriciaJ, RN]

Most of my patients who complained of referred gas pain were generally sitting up at the time. I would always have them put down the head of the bed and lie flatter, so the gas bubble could move down off the diaphragm. Left side-lying often helped, with the right knee drawn up toward the chest. I would also get them a warm blanket, keep it somewhat folded and place it where the pain was most severe. This seemed to help, but I'm not sure if it did anything physiological, or just the TLC factor.

Didn't have a lot of luck with pain meds, unless it was for incisional pain. Gas, not so much.

[TraumaORnurse]

After multiple laparoscopic surgeries and enduring the shoulder pain, I finally found the only thing that helped was a heating pad on my shoulder. It helped tremendously and the last two surgeries (since I found this helps) have been much more bearable.

[msdnl53]

Thanks because I just had laparoscopic surgery yesterday and they warned me about the shoulder pain (which I don't have) but didn't tell me about the crepitus. It feels like bubble wrap on my ribs and is tender.

[wanderlust99]

I didn't have shoulder pain, but chest pain post op. The only thing that helped was walking throughout the hospital.

[CarryThatWeight, BSN]

Last month I had a laparoscopic procedure and I had pain in my shoulders and ribs for five days. I was up and walking quite a bit, shifting positions, heating pad, taking gas x, anything I could think of other than taking opiates. Nothing really worked. On day 6, it just got better. So I vote for time being the most effective intervention! My doctor told me that thinner people tend to have discomfort from the CO2 for a longer period of time than larger people. I wonder if that's why kiddos complain of it?

[amanda827]

No I worked as a CNA @ a LTCF and am a small nurse like you. Managers look more at your common sense and the care u give the patients. Being short is harder on your back because u don't have the leverage of a tall person. (Sorry to say)

Go in an

Zc"@&-nak

[firstinfamily, RN]

IF it is little ones who are recovering from surgery and there are rocking chairs available, you might try to "rock" the gas away. They may not feel like walking, but rocking may help. Motion seems to be the trick.

[JustcallmeNurse]

I work on a Urology surgical floor and patients frequently complain about gas pains, including radiating up into their shoulder (from irritating the phrenic nerve and diaphragm like another poster said). The one thing that the docs push for gas pain is walking. And more walking. And walking again. :-) I have to say, it does seem to help the majority of the patients.

[firstinfamily, RN]

It is pressure on the phrenic nerve from the gas that causes the discomfort in the shoulder!!

[stargarden]

I have found there is nothing that really seems to relieve this pain other then time. We get patients all the time who get adequate amounts of pain meds and still get no relief. It sucks.