Free Essay. Research Findings on Pain Control After Laparoscopic Cholecystectomy

Research carried out on patients between the ages of 18 and 65 evaluated the patients who were going for elective cholecystectomy which resulted in shoulder pain. The basic intervention consisted of applying an exaggerated lithotomy position to prevent shoulder pain after laparoscopic cholecystectomy. The outcome proved that with 10 minutes of positioning patients to lithotomy pain relief was reported (Aydemir, Aslan, Karabacak, and Akdas, 2018). The Laparoscopic Cholecystectomy is the most preferred standard technique for gallbladder disease in both elective and acute surgery, and more than 25 years have passed since it was introduced. Its advantages include the fact that it involves less blood loss, shorter incisions, and faster recovery as compared with open surgery. Significant changes such as technological advancement and the growth of knowledge as well as skills have allowed the addition of several guidelines on Laparoscopic Cholecystectomy. How can pain be managed for patients who have undergone Laparoscopic Cholecystectomy?

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It is important to control pain because it helps in identifying the symptom management techniques that effectively reduce the distress experienced after Laparoscopic Cholecystectomy. Pain is a significant symptom after surgery, and it was found that it impacts morbidity and sleep in a direct way. Ambulatory surgery has been gaining popularity, and an average 30% to 45% of adult patients who have undergone LC experience pain as a significant symptom affecting their morbidity and safety after surgery. Most patients report that they were uninformed on how to manage pain best if their medications did not work, and they often failed to continue with pain medication even when they were experiencing pain. Ineffective pain control after surgery may influence the recovery of patients as well as their ability to return to their usual activities of daily living. It can also make medication expensive because the pain can last for up to three months, with the patient lacking the proper care to make morbidity easy and safe.

The overall pain experienced by patients after a laparoscopic Cholecystectomy includes incisional pain, shoulder pain, and visceral pain. All of these have to be controlled to allow for the safety of the patients as well as low morbidity. The clinical problem of pain control is important because it can delay a patient from being discharged from the hospital or influence their well-being at home. Patients need multimodal pain management options to help them control pain after surgery and, in the process, reduce the cost of care and improve both their safety and morbidity. One solution involves peritoneal irrigation with sodium bicarbonate, which reduces the intensity of postoperative shoulder tip pain as well as helps to improve the quality of life of patients who have undergone Laparoscopic cholecystectomy.

Poorly controlled postoperative pain brings numerous negative consequences such as increased morbidity, which affects other aspects of the life of the patient in question. Also, it may cause prolonged use of opioids to help manage the pain, and this prolonged use can be very costly to the patient and hence may increase the costs of medication and healthcare, among other things. Studies show that in 80% of patients in the US, post-operative pain is not adequately managed, and this is the reason it is very critical that alternatives pain control measures need to be identified to help manage pain after Laparoscopic cholecystectomy. It is also notable that caregivers play an essential role in the success of any ambulatory surgery recovery process, and this is because they aid patients in recovery and give reassurance. In addition, postoperative pain affects the patients in several ways, such as by limiting mobility, causing an inability to rest, and affecting the ability to drink and eat. All these symptoms tend to be interrelated and hence cause distress to patients.

Reliability of Research Article

Reliability is a term used to describe the degree to which a research method produces stable and consistent results. The measurement procedure used to collect data has to be of decent quality and give the same repeated results under similar conditions. In the nursing quantitative research article, the reliability method that was applied in the study involved Interrater Reliability. Interrater reliability consists of the extent to which consistent judgments by observers are provided for a given sample group. Here different sets of the sample group are tested, and the observers are supposed to provide a consistent judgment for their observation. For instance, in the student research article on the effects of the pronounced impact of Lithotomy position on shoulder pain after Laparoscopic Cholecystectomy, the data collection method used involved there was the experimental group with whom the exaggerated lithotomy position was given and the other was the control group which received analgesia. Here, interrater reliability has been used in two different settings, one involving the exaggerated position and the other receiving the analgesic (Odom-Forren, Reed, and Rush, 2018). Their data was then observed separately by the same observers and recorded separately.

Validity

Validity involves the measure towards which various scores represent the variables that they are intended. Here the case of reliability is applied as a measure to test and measure the validity of the score. The validity used here is Criterion validity, where one variable is used to determine the outcome or measure of another. For the research article, the validity measure or type of validity that was applied in the study involves Criterion Validity, which analyzes the extent by which scores of people involved on a measure correlate with other variables. For instance, in the research article, the hypothesis suggested both the application of the exaggerated lithotomy position following laparoscopic cholecystectomy, which relieves pain as the first hypothesis and that the hypothesis would positively affect the respiratory functioning of the patients. It is a presentation of two correlated aspects in the research article, and it brings out the aspect of validity because the first hypothesis to the study will help determine the respiratory functions of the patients in the research.

The application of the exaggerated lithotomy position after the laparoscopic cholecystectomy correlates with the respiratory functions of patients, and this was the intended result in the methods of data collection. Criterion validity requires that one variable be related to the other, and this has been manifested in the instance demonstrated in the data collection methods, as pointed out in the research article.

Strengths of the Methodology

The major strength demonstrated in the research article is that the methodology applied was consistent across the research process. Consistency applies in the process through which the participants were selected, and all of them followed through the right channels toward the realization of the research process. Consistency as a strength leads to reliability, which makes the presentation of the research more presentable and geared towards the success of the study.

The other strength in the research process is that the research followed the various set ethical provisions for any research process. One of the most important ethical requirements that the study adheres to is being able to provide the participants with consent forms that allow them to be fully aware of what is expected of them and the reason why they are taking part in the process. Consent forms are legally required provisions that ensure the protection of the participants and more so by providing them with the necessary knowledge that they ought to know about the research process.

PICO analysis is an evidence-based medicine framework that helps in the framing of a clinical health-based question. The facts that are related in the nursing practice include;

Pain in the shoulder right after the laparoscopic cholecystectomy arises as a result of damage of tissue cells, also due to nociceptor sensitization and lastly due to the activation of the central pain because of injection of carbon dioxide, and as a nursing professional, the understanding of the cause of the shoulder pain is critical in further research and consequently treatment of the condition (Aydemir, Aslan, Karabacak, and Akdas, 2018).

The position change is applied in pain alleviation through the improvement of blood circulation and the prevention of muscle tension and spasms.

Postoperative pain also affects the various development of tachycardia directly and also leads to poor healing of wounds and even insomnia.

Aydemir, O., Aslan, F. E., Karabacak, U., & Akdas, O. (2018). The effect of exaggerated lithotomy position on shoulder pain after laparoscopic cholecystectomy. Pain Management Nursing, 19(6), 663-670.

The other presentable fact on the below website include the following;

Agresta, F., Campanile, F. C., Vettoretto, N., Silecchia, G., Bergamini, C., Maida, P., ... & Esposito, M. G. (2015). Laparoscopic cholecystectomy: consensus conference-based guidelines. Langenbeck's archives of surgery, 400(4), 429-453.

Laparoscopic cholecystectomy is defined as the treatment of choice for every patient that has acute cholecystitis.

Surgical operations of patients with this condition should immediately be treated after the symptoms of Laparoscopic cholecystectomy. (Agresta et al., 2015)

Electrocautery is an unsafe means to control of the cystic artery.

Restatement of PICO question: Laparoscopic Cholecystectomy as a treatment of Exaggerated Lithotomy Position on Shoulder Pain.

Conclusion

The positioning of the nonpharmacologic intervention during the implementation of the independence of nurses is an efficient practice that helps in the lowering of pain as related to the NSAID patient application with the postoperative shoulder injury right after the laparoscopic cholecystectomy. During the consideration of the effects of the nonpharmacologic practice, nurses are a vital element that creatively helps in handling and taking care of patients while at home and ensuring that they are well serviced to that end.

References

Agresta, F., Campanile, F. C., Vettoretto, N., Silecchia, G., Bergamini, C., Maida, P., ... & Esposito, M. G. (2015). Laparoscopic cholecystectomy: consensus conference-based guidelines. Langenbeck's archives of surgery, 400(4), 429-453.

Aydemir, O., Aslan, F. E., Karabacak, U., & Akdas, O. (2018). The effect of exaggerated lithotomy position on shoulder pain after laparoscopic cholecystectomy. Pain Management Nursing, 19(6), 663-670.

Odom-Forren, J., Reed, D. B., & Rush, C. (2018). Postoperative symptom distress of laparoscopic cholecystectomy ambulatory surgery patients. Journal of PeriAnesthesia Nursing, 33(6), 801-813.