Background The aims of this study were to assess first day postdischarge pain, nausea and patient satisfaction in ambulatory breast cancer surgical patients, after diagnostic and breast conserving procedures. Methods A total of 781 women, aged 18–85 years were included in this prospective, cross‐sectional study. All patients received standardized multimodal pain prophylaxis with paracetamol, COX‐II inhibitor, dexamethasone and wound infiltration with local anaesthetics. Nausea prophylaxis was provided with ondansetron. Most patients received general anaesthesia with propofol and remifentanil. Data were collected using a validated questionnaire during telephone follow‐up on the first postoperative day. Results The response rate was 94.5%. NRS ≥ 4 was reported by 5.3% at rest, by 17% during activity and by 30.7% as the worst pain score. Young age was strongly associated with more pain both at rest, during activity and regarding worst pain since discharge. Postdischarge nausea was present in 17.8%, and vomiting in 1.2%. High pain score during activity and higher level of worst pain, were associated with nausea. There was no association between nausea and age, type of anaesthesia, surgical procedure or pain at rest. Patient satisfaction was high (97.8%–99.7%) regarding information, time for discharge and overall satisfaction. Conclusion Pain scores and incidence of nausea were generally low on the day after surgery. Young age was a strong predictor for postdischarge pain. A high worst pain score and high pain score during the activity were associated with postdischarge nausea. Patient satisfaction was high.

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Intensivsykepleier Postoperativ seksjon, Oslo universitetssykehus, Ullevål Sykepleier, seniorforsker og professor II Avdeling for FoU, Oslo universitetssykehus, Ullevål og Medisinsk fakultet, Universitetet i Oslo Overlege og professor II Anestesiavdelingen, Oslo universitetssykehus, Ullevål og Medisinsk fakultet, Universitetet i Oslo Authors Mi Stjernberg Tone Rustøen Johan Raeder same day, accounts for about 60 per cent of all elective surgery in Norway. Postoperative nausea is a known problem after anaesthesia and surgery, and one that can cause discomfort and, at worst, complications for the patient. In an ambulatory surgery setting, postoperative nausea can also lead to a prolonged stay in the postanaesthesia care unit or a need for unplanned hospital admission, which results in increased costs. International studies show that 37-57 per cent of patients report postoperative nausea after arriving home from ambulatory surgery. Objective: To investigate what percentage of our ambulatory surgery patients experience postoperative nausea after discharge. We also wanted to investigate whether any patient groups are particularly vulnerable. Method: The study is a cross-sectional study. Telephone follow-up the day after surgery was used to collect data using a structured questionnaire with set response options. Results: A total of 2952 patients were included in the study and the response rate was 99 per cent. A general anaesthetic was administered to all patients in the form of total intravenous anaesthesia. Based on known risk factors, the majority of the sample had an increased risk of developing postoperative nausea. The study showed an incidence of postoperative nausea the day after the operation of 16 per cent, of which 14 per cent were slightly nauseous and only 2 per cent were very nauseous. Conclusion: The study shows that the incidence of postoperative nausea after ambulatory surgery can probably be reduced through systematic, multimodal antiemetic prophylactic treatment. Please note we have corrected the following numbers in table 3: Whole sample n = 2794 (was n = 3022) Open gastric surgery n = 154 (was n = 201) Anorectal surgery n = 373 (was n = 390) Major breast cancer surgery n = 533 (was n = 542) Minor breast cancer surgery n = 471 (was n = 626) Correction 26.02.2019