• Hideki Kawamura, Shigenori Homma, Ryoichi Yokota, Hiroshi Watarai, Kentaro Yokota, and Yukifumi Kondo.
• Department of Surgery, JA Sapporo Kosei Hospital, Sapporo, Japan. h.kawamura@ja-hokkaidoukouseiren.or.jp
• Surg Endosc. 2009 May 1; 23 (5): 991-5.

BackgroundLaparoscopic gastrectomy is reported to cause little pain. However, only the total number of analgesics used has been studied to date. Because pain is a subjective experience, its evaluation requires indicators for the subjective assessment.MethodsPain was evaluation for patients after open distal gastrectomy (ODG, 52 cases), laparoscopically assisted distal gastrectomy (LADG, 112 cases), open total gastrectomy (OTG, 18 cases), and laparoscopically assisted total gastrectomy (LATG, 33 cases). The patients were administered continuous epidural anesthesia for 2 days after the surgery. The Wong-Baker FACES pain rating scale was used to evaluate the differences in pain. Each patient was evaluated from postoperative day (POD) 1 to POD 7, and temporal changes in pain were studied comparatively between ODG and LADG and between OTG and LATG.ResultsPeak pain scores were recorded on POD 3 for both distal and total gastrectomy. The scores decreased over time after POD 3. There was no significant difference in scores between open and laparoscopic gastrectomy up to POD 2, but lower scores were shown on PODs 3, 4, and 5 for LADG and on days 3 and 4 for LATG.ConclusionsThe pain score for laparoscopic gastrectomy was low. There was no significant difference in pain between procedures while epidural anesthesia was in effect. Pain subsided earlier with laparoscopic than with open gastrectomy. The same characteristics were observed with both LADG and LATG.

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