Effect of Preoperative Trapezius Myalgia on Postoperative Pain

Introduction: Trapezius myalgia (TM) is the chronic pain of trapezius muscle, one of the most common reasons for shoulder pain seen in a common population. The aim of our study is to determine the effects of an existence of preoperative TM to the postoperative pain in the patients, who underwent a laparoscopic cholecystectomy. Methods: After receiving an ethical committee approval, we have included 60 ASA 1-2 patients who underwent a laparoscopic cholecystectomy surgery in the general surgery operating room in University of Health Sciences Turkey, Istanbul Training and Research Hospital between January and June 2015. The patients who were classified as ASA 3-4, had head and neck surgery or trauma, operations which had started as the laparoscopic procedures but then had to be performed as an open surgery, patients who had rheumatological and neurological diseases, tendinitis that affects the shoulder joints, and patients who had to have the emergency surgeries were excluded in this study. Patients were divided into two groups, one with (TM+) and who were not having (TM), when evaluated preoperatively. Each group had analgesia by a patient-controlled device. Using Numeral Rating scale demographical data, shoulder and umbilical pain levels were evaluated, and postoperative analgesic needs and doses were recorded in the case files. Results: Five patients who were excluded; n=26 in TM+ group and n=29 in TM group were taken. There was no significant demographic difference found between two groups. No statistically significant difference was found between TM+ and TM- groups (p>0.05). While no statistically significant difference was established in the tramadol doses between two groups, a total of ten patients out of 26 TM+ had shoulder pain, and additional analgesic need was found statistically increased in TM+ group (p<0.001). Conclusion: We have concluded that the existence of a preoperative TM increased the need for analgesics postoperatively, this could be important for choosing the analgesic regimen, and that the TM should be considered after a laparoscopic cholecystectomy.