Sodium Bicarbonate Sub-Diaphragmatic Irrigation Relieves Shoulder Pain After Total Laparoscopic Hysterectomy: A Randomized Controlled Trial.

STUDY
OBJECTIVE: To determine whether sub-diaphragmatic irrigation with sodium bicarbonate would relieve post-laparoscopic shoulder pain (PLSP) after total laparoscopic hysterectomy.
DESIGN: Randomized double-blinded trial.
SETTING: Teaching hospital. PATIENTS: Seventy patients undergoing total laparoscopic hysterectomy (TLH) for benign indications. INTERVENTION: We randomly allocated patients to intervention or control groups where sodium bicarbonate containing flushing liquid or normal saline was irrigated sub-diaphragm before sewing. MEASUREMENT & MAIN
RESULTS: The primary outcome was PLSP following surgery measured by a numerical rating scale (NRS) (0 = no pain; 10 = worst pain imaginable). Secondary outcomes were abdominal incisional and visceral pain, analgesic use, and sodium bicarbonate related side effects. The incidence of PLSP in intervention group was significantly lower than that in control group (P < 0.05). Contrarily, incisional and visceral pain was similar in both groups (P = 0.1). The consumption of rescue analgesics in the intervention group was lower than that in the control group. Side effects were comparable in both study groups.
CONCLUSION: Sub-diaphragmatic irrigation with sodium bicarbonate could effectively reduce shoulder pain, but not abdominal incisional and visceral pain, in patients undergoing TLH without an increase in side effects. REGISTRATION INFORMATION: Clinical trial registry number: http://www.chictr.org.cn/ (ChiCTR2100041765). REGISTRATION
FINDINGS: http://www.chictr.org.cn/showproj.aspx?proj=66721 Link to clinical trial page and data repository: http://www.medresman.org.cn/pub/cn/proj/projectshshow.aspx?proj=2992.

Dear editor

We thank the editor-in-chief for giving us an opportunity to respond to the letter from Dong et al regarding our study. We are also thankful to Dong, Qunya and Wu, Wenzhe for their attention to our work and their expert opinion. It is a great honor that our study has been read precisely by other researchers. Herein, we provide our responses to their concerns regarding our work.

First, we searched the Web of Science Core Collection using the terms “acupuncture OR electroacupuncture” AND “cervical pain OR neck pain” on December 4, 2020. This search identified 658 articles at that time. However, on November 2, 2021, a search with the same search terms retrieved in 656 articles. After that, we searched using the suggested search terms, “acupuncture OR electroacupuncture OR electro-acupuncture OR warm needling OR fire needing OR plum blossom needling” AND “cervical pain OR neck pain OR cervicodynia* OR cervicalgia* OR cervicogenic pain OR neckache” with “topic,” and the search retrieved 665 articles. Compared to the results of the search with the previous terms on the same day, there were nine additional articles.

None of the nine articles met the inclusion criteria of our study. One study1 was not written in English, five studies2–6 did not deal with neck pain, two studies7,8 did not use acupuncture as an intervention, and one study9 was not a human study. Therefore, the suggested search method will not change the results of our study.

However, we agree with the researchers’ concise scheme when searching for data. We believe that the more specific the search term, the higher the quality of the data. However, our results were not affected by the search terms. Therefore, we believe that more detailed search terms will be needed in future bibliometric studies to include the maximum number of eligible studies.

Second, as rightly identified by Dong et al, the exact database that we used was the Web of Science Core Collection.

We hope that other researchers will refer to our work and communication for their research using bibliometric analysis.