Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Maneuvers to Decrease Upper and Shoulder Pain After Gynecologic Laparoscopic Surgery
Brief Summary: Laparoscopic surgery is becoming a major procedure, owing to smaller incisions, shorter hospitalizations, and less post-operative pain as compared with traditional laparotomies. However, there is marked interindividual variability of post-operative shoulder-tip pain following laparoscopic surgery. The incidence of shoulder pain varies from 35% to 80% and ranges from mild to severe. In some cases, it has been reported to last more than 72 hours after surgery.

The hypothesis of post-operative shoulder-tip pain is that carbon dioxide induced phrenic nerve irritation causes referred pain to C4. Therefore, the investigators should try to do is that if the investigators could reduce carbon dioxide retention in the pelvic cavity.

This clinical controlled trial is tried to find out the practical and clinical maneuver to reduce post-operative should-tip pain following laparoscopic surgery.


Options:
A: Arm Label: Control; Type: NO_INTERVENTION; Interventions: N/A | Arm Label: Intervention; Type: EXPERIMENTAL; Interventions: Procedure: Recruitment manouver | Intervention Type: PROCEDURE; Name: Recruitment manouver; Assigned to Arm(s): Intervention
B: Arm Label: instillation of normal saline 50ml under the diaphragm; Type: PLACEBO_COMPARATOR; Interventions: Other: normal saline | Arm Label: the instillation of 0.5% bupivacaine under the diaphragm; Type: EXPERIMENTAL; Interventions: Procedure: Intraperitoneal instillation of bupivacaine | Arm Label: CO2 removal by means of a pulmonary recruitment maneuver; Type: EXPERIMENTAL; Interventions: Procedure: CO2 removal by means of a pulmonary recruitment maneuver | Arm Label: the instillation of bupivacaine + CO2 removal by maneuver; Type: EXPERIMENTAL; Interventions: Procedure: Intraperitoneal instillation of bupivacaine +CO2 removal by means of a pulmonary recruitment maneuver | Intervention Type: PROCEDURE; Name: Intraperitoneal instillation of bupivacaine; Assigned to Arm(s): the instillation of 0.5% bupivacaine under the diaphragm | Intervention Type: PROCEDURE; Name: CO2 removal by means of a pulmonary recruitment maneuver; Assigned to Arm(s): CO2 removal by means of a pulmonary recruitment maneuver | Intervention Type: PROCEDURE; Name: Intraperitoneal instillation of bupivacaine +CO2 removal by means of a pulmonary recruitment maneuver; Assigned to Arm(s): the instillation of bupivacaine + CO2 removal by maneuver | Intervention Type: OTHER; Name: normal saline; Assigned to Arm(s): instillation of normal saline 50ml under the diaphragm
C: Arm Label: Pulmonary recruitment maneuver; Type: EXPERIMENTAL; Interventions: Procedure: Pulmonary recruitment maneuver | Arm Label: Intraperitoneal normal saline infusion; Type: EXPERIMENTAL; Interventions: Procedure: Intraperitoneal normal saline infusion | Arm Label: combined group; Type: EXPERIMENTAL; Interventions: Procedure: combined group | Arm Label: Control group; Type: PLACEBO_COMPARATOR; Interventions: Procedure: Control group | Intervention Type: PROCEDURE; Name: Pulmonary recruitment maneuver; Assigned to Arm(s): Pulmonary recruitment maneuver | Intervention Type: PROCEDURE; Name: Intraperitoneal normal saline infusion; Assigned to Arm(s): Intraperitoneal normal saline infusion | Intervention Type: PROCEDURE; Name: combined group; Assigned to Arm(s): combined group | Intervention Type: PROCEDURE; Name: Control group; Assigned to Arm(s): Control group
D: Arm Label: Deep neuromuscular blockade; Type: ACTIVE_COMPARATOR; Interventions: Drug: Rocuronium | Arm Label: Moderate neuromuscular blockade; Type: PLACEBO_COMPARATOR; Interventions: Drug: placebo | Intervention Type: DRUG; Name: Rocuronium; Assigned to Arm(s): Deep neuromuscular blockade | Intervention Type: DRUG; Name: placebo; Assigned to Arm(s): Moderate neuromuscular blockade

Answer: C