From the *Istanbul Haydarpasa Numune Training and Research Hospital, Istanbul, Turkey; † School of Nursing, Acıbadem University, Istanbul, Turkey; ‡ Palliative Care Service, Department of Anesthesiology and Reanimation, Us ¸ak Public Hospital, Us ¸ak, Turkey. Address correspondence to € Ozg€ ul Aydemir, R.N., M.Sc., Istanbul Haydarpasa Numune Training and Research Hospital, Istanbul 34668, Turkey. E-mail: ozgul6761@gmail. com Received November 7, 2016; Revised April 5, 2018; Accepted April 25, 2018. 1524-9042/$36.00 Ó 2018 by the American Society for Pain Management Nursing https://doi.org/10.1016/ j.pmn.2018.04.012 The Effect of Exaggerated Lithotomy Position on Shoulder Pain After Laparoscopic Cholecystectomy --- € Ozg € ul Aydemir, RN, MSc, * Fatma Eti Aslan, PhD, † € U kke Karabacak, PhD, † and € Ozlem Akdas ¸, MD ‡ - ABSTRACT : Background: The exaggerated lithotomy position with the expertise of nurses can be successful solution for the patients who have the post- operative shoulder pain after laparoscopic cholecystectomy. Aims: This study aimed to determine the effect of applying an exaggerated lithotomy positions to patients who had laparoscopic cholecystec- tomy to relieve shoulder pain. The study was conducted on non- randomized groups and made as a semiexperimental study with a pretest/post-test control group design. Design, Settings, and Subjects/ Participants: The study was conducted on 102 patients who had elec- tive laparoscopic cholecystectomy and agreed to participate in this study after they met the inclusion-exclusion criteria in the general surgery clinic of a training and research hospital in Istanbul between December 12, 2012, and June 30, 2013. Methods: The pain levels (10 minutes before and after positioning) and peripheral oxygen saturation (SPO 2 ) levels (1 minute, 5 minutes, and 10 minutes before and after positioning—total 6 times) of the patients were measured using a visual analog scale and pulse oximetry, respectively. The pain levels and the analgesic (pethidine hydrochloride and diclofenac so- dium) usage of the patients in both the experimental and the control group were compared. Results: The exaggerated lithotomy position appreciably lowered the shoulder pain of the patients in the experi- mental group (t ¼ 12.663; p ¼ .000 < .001). It also increased peripheral saturation levels of the patients more rapidly compared with those in the control group receiving analgesics (t ¼ 17.693; p ¼ .000 < .005). In addition, it decreased the need to use additional analgesics and opioids (t ¼ 2.14; p ¼ .037). Conclusions: In this study the exaggerated lithot- omy position was found to be fast and effective for relieving shoulder pain after laparoscopic cholecystectomy, decreased the need to use additional analgesics and opioids, and, in conjunction with pain con- trol, also contributed to improvements in respiratory functions. Ó 2018 by the American Society for Pain Management Nursing Pain Management Nursing, Vol -, No - (--), 2018: pp 1-8 Original Article