CC BY 4.0 · Journal of Health and Allied Sciences NU 2023; 13(04): 509-517
DOI: 10.1055/s-0042-1760234
Original Article

Postoperative Discomfort Among Laparotomy Patients from a Selected Hospital at Mangaluru: An Observational Study

1   Department of Medical-Surgical Nursing, Nitte (Deemed to be University), Nitte Usha Institute of Nursing Sciences (NUINS), Mangaluru, Karnataka, India
2   Dept of Community Health Nursing, Nitte (Deemed to be University), Nitte Usha Institute of Nursing Sciences (NUINS), Mangaluru, Karnataka, India
Gincy Joseph
3   Emergency Nursing and Life Support Course, RGUHS-JeevaRaksha Trust, Bengaluru, Karnataka, India
› Author Affiliations


Background Factors causing postoperative discomfort after laparotomy are numerous and must be explored in depth. The postoperative distress may significantly affect the patient's state of well-being. Hence, the present study aims to assess the factors contributing to discomfort after laparotomy.

Aim The aim was to assess and compare the discomfort between open and laparoscopic abdominal surgery.

Objectives of the Study

1. To analyze the causes of patient's discomfort after abdominal surgery.

2. To compare the discomfort between open and laparoscopic abdominal surgery.

3. To determine the association between pain and selected variables among open and laparoscopic abdominal surgery.

Materials and Methods An exploratory approach with a prospective observational design was adopted for this study. Using the purposive sampling technique, 100 patients were selected to open and 100 to laparoscopic abdominal surgery groups. Data were collected using demographic and clinical proforma and standardized postoperative discomfort inventory 6 and 24 hours after the surgery. The assessment focused on the study variables such as symptoms after the surgery and the factors contributing to the postoperative discomfort.

Statistical Analysis The collected data were analyzed using descriptive and inferential statistics using the SPSS software version 20.

Results Among 200 participants, most of the open (68%) and laparoscopic abdominal surgeries (42%) belong to 25 to 35 years of age. Also, 54% and 13% were diabetic in open and laparoscopic abdominal surgery groups, respectively. Most samples (56% in open and 68% in laparoscopic surgery) stayed 5 and 10 hours in postoperative ICU. In open and laparoscopic abdominal surgeries, pain is the primary (100%) cause of postoperative discomfort after 6 hours of surgery. Movement restriction is also the reason for significant discomfort both in open (98%) and laparoscopic (100%) abdominal surgeries.

In contrast, pain (99% and 100%), movement restriction (92% and 95%), and abdominal distention (61% and 34%) were the major problems contributing to the patient's discomfort after 24 hours of both open and laparoscopic surgeries too. There was a significant difference in causes of patient discomfort between open and laparoscopic abdominal surgery after 6 hours (P < 0.05), except for discomfort related to IV drip (P = 0.852), constipation (P = 0.2), and chills (P = 0.6).

Conclusion Even though pain is the major distressing factor both in open and laparoscopic surgeries, the current study highlights a few other factors that affect postoperative recovery. Nurses' attention to such distressing factors will fasten patients' recovery and quality of life after abdominal surgery.

Ethical Approval

The study is approved by the Institutional review board approval (NUINS/CON/NU/IEC/2019-20/1481).

Publication History

Article published online:
24 January 2023

© 2023. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (

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  • References

  • 1 Hu MG, Ou-yang CG, Zhao GD, Xu DB, Liu R. Outcomes of open versus laparoscopic procedure for synchronous radical resection of liver metastatic colorectal cancer: a comparative study. Surg Laparosc Endosc Percutan Tech 2012; 22 (04) 364-369
  • 2 Kapritsou M, Korkolis DP, Konstantinou EA. Open or laparoscopic surgery for colorectal cancer: a retrospective comparative study. Gastroenterol Nurs 2013; 36 (01) 37-41
  • 3 Keller DS, Delaney CP, Hashemi L, Haas EM. A national evaluation of clinical and economic outcomes in open versus laparoscopic colorectal surgery. Surg Endosc 2016; 30 (10) 4220-4228
  • 4 Andión Ó, Cañellas M, Baños JE. The postoperative discomfort inventory: a psychometric analysis. J Nurs Educ Pract 2016;6(05):
  • 5 Brusciano L, Gambardella C, Terracciano G. et al. Postoperative discomfort and pain in the management of hemorrhoidal disease: laser hemorrhoidoplasty, a minimal invasive treatment of symptomatic hemorrhoids. Updates Surg 2020; 72 (03) 851-857
  • 6 Elsaid RM, Namrouti AS, Samara AM, Sadaqa W, Zyoud SH. Assessment of pain and postoperative nausea and vomiting and their association in the early postoperative period: an observational study from Palestine. BMC Surg 2021; 21 (01) 177
  • 7 Fan YL, Qian JL, Ma EL, Stricker PA, Zuo YX. Incidence and risk factors of postoperative severe discomfort after elective surgery under general anesthesia: a prospective observational study. J Perianesth Nurs 2021; 36 (03) 253-261
  • 8 Ye H, Chen R, Lian X. et al. Risk factors associated with postoperative pain and discomfort in oculoplastic surgery with general anesthesia: a prospective study. J Pain Res 2018; 11: 407-415
  • 9 Seok Y, Suh EE, Yu SY, Park J, Park H, Lee E. Effectiveness of integrated education to reduce postoperative nausea, vomiting, and dizziness after abdominal surgery under general anesthesia. Int J Environ Res Public Health 2021; 18 (11) 6124
  • 10 Allvin R, Rawal N, Johanzon E, Bäckström R. Open versus laparoscopic surgery: Does the surgical technique influence pain outcome? Results from an international registry. Pain Res Treat 2016; 2016: 4087325
  • 11 Chanif C, Petpichetchian W, Wimo W. Acute postoperative pain of Indonesian patients after abdominal surgery. Nurse Media Journal of Nursing 2012; 2 (02) 409-420
  • 12 Andión O, Cañellas M, Baños JE. O A. Physical well-being in postoperative period: a survey in patients, nurses and physicians. J Clin Nurs 2014;23(9-10):1421–1429
  • 13 Gasparini G, Torroni A, Di Nardo F. et al. OSAS surgery and postoperative discomfort: phase I surgery versus phase II surgery. BioMed Res Int 2015; 2015: 439847
  • 14 Zegerman A, Ezri T, Weinbroum AA. Postoperative discomfort (other than pain) - a neglected feature of postanesthesia patient care. J Clin Monit Comput 2008; 22 (04) 279-284
  • 15 Tian C, Yu Y, Mao J, Davidson PM. Perceived discomfort, pain and nonpain symptoms in a postanesthesia care unit: an observational study. J Perianesth Nurs 2019; 34 (05) 1032-1039
  • 16 Robleda G, Baños JE. Health care professionals' assessment of patient discomfort after abdominal surgery. J Perianesth Nurs 2021; 36 (05) 553-558
  • 17 Huppe M, Kemter A, Schmidtke C, Klotz KF. Postoperative complaints: gender differences in expectations, prevalence, and appraisal. Anaesthetist 2013; 62 (07) 528-536
  • 18 Amirshahi M, Behnamfar N, Badakhsh M. et al. Prevalence of postoperative nausea and vomiting: A systematic review and meta-analysis. Saudi J Anaesth 2020; 14 (01) 48-56
  • 19 Sawatzky JA, Rivet M, Ariano RE, Hiebert B, Arora RC. Post-operative nausea and vomiting in the cardiac surgery population: who is at risk?. Heart Lung 2014; 43 (06) 550-554
  • 20 Cantekin K, Yildirim MD, Delikan E, Çetin S. Postoperative discomfort of dental rehabilitation under general anesthesia. Pak J Med Sci 2014; 30 (04) 784-788
  • 21 Kim TS, Choi SE, Won RS. Undesirable symptoms of patients in the postanesthesia recovery situations. Korean J Anesthesiol 2001; 40 (05) 619-624