Post-operative gas pains

[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?

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

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.

Edited Oct 12, 2014 by JustcallmeNurse
spelling error

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

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.

[OhioCCRN, MSN, NP]

*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.