Influencing factors for delayed discharge following day surgery: A retrospective case–control study

Zhu, Wei; Huang, Meizhu; Dai, Yan; Li, Jiping

doi:10.1111/ijn.12951

Cited by 2 publications

(6 citation statements)

References 25 publications

(46 reference statements)

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“…The length of hospital stay after drainage removal in the study group was shorter than that of the control group (2.23 days vs 2.82 days), but the difference was not significant because some patients asked to delay their discharge until the weekend or based on their personal condition. Roughly consistent with Zhu's 14 study, the control of fever after surgery could shorten the hospital stay.…”

Section: Discussionsupporting

confidence: 78%

“…Fortunately, almost all of the patients' temperatures gradually became normal after observation or antipyretic treatments before discharge. Similar to the reports of many previous studies, the evaluation of these fevers was costly and time‐consuming, and they made the patients uncomfortable and could increase their medical expenditures, prolong their hospital stay and waste healthcare resources 3,4,10–14 …”

Section: Introductionmentioning

confidence: 71%

“…Similar to the reports of many previous studies, the evaluation of these fevers was costly and time-consuming, and they made the patients uncomfortable and could increase their medical expenditures, prolong their hospital stay and waste healthcare resources. 3,4,[10][11][12][13][14] To address this challenging issue, we carried out a thorough literature review. To the best of our knowledge, no previous research has focused on fever after the removal of drainage tubes.…”

mentioning

confidence: 99%

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A Randomized Study on the Prophylactic Use of Acetaminophen to Prevent Fever after the Removal of Drainage Tubes for Lumbar Surgery

Yang

Xing

et al. 2022

Orthopaedic Surgery

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Study design: a prospectively random clinical trialObjective: To explore the e cacy of prophylactic use of Acetaminophen in preventing fever after the removal of tube drainage in lumbar surgery.Summary and background data: Many inpatients encountered a fever in the rst 24 hours when the drainage tube was removed. When fevers appeared, it was costly to exclude the possibility of deep infection and always failed to identify the etiology. Just like the postoperative fever, we suggested that the fever was caused by the normal in ammatory response, and tried to gure out whether the prophylactic use of Acetaminophen could lower the possibility of fever or not.Methods: 183 consecutive patients undergoing lumbar spine surgery were prospectively randomized into 2 groups. 91 patients were allocated into the study group, they would receive a pill of Acetaminophen (Tylenol, 650mg) before the removal of lumbar tube drainage, and another one at 8p.m. The rest 92 patients were divided into the control group, they were treated in routine treatment without Acetaminophen. In the rst 24 hours, a temperature higher than 37.7°C was de ned as fever. The 2 groups were then compared for differences in age, gender, height, weight, body mass index (BMI), surgical segments, surgical time, blood loss, blood transfusion, American Society of Anesthesiologists (ASA) score, duration of the tube drainage, total volume of the drainage collection, variation of the levels of WBC, CRP, hospital stay since the removal of drainage to discharge and the rate of fever. Results: There were no differences in all the basic information of 2 groups, but the fever rate of the 2 groups had signi cant differences (P=0.006), the fever rate of the study group (14/91, 15.38%) was signi cant lower than the control group (30/92, 32.61%).Conclusion: Fever after the removal of tube drainage was caused by normal in ammation response, and a small dose of acetaminophen could signi cantly lower the possibility fever.

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Section: Discussionsupporting

confidence: 78%

Section: Introductionmentioning

confidence: 71%

mentioning

confidence: 99%

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A Randomized Study on the Prophylactic Use of Acetaminophen to Prevent Fever after the Removal of Drainage Tubes for Lumbar Surgery

Yang

Xing

et al. 2022

Orthopaedic Surgery

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“…In general, young patients tend to have more pain than elderly [20 ▪ ], and females more than men. Psychosocial aspects may be important, patients with a history of anxiety or depression are more prone to pain, as are a catastrophizing attitude [3 ▪ ,18,21 ▪ ,22]. In chronic pain patients there seem to be additional risk of pain associated with inflammatory states such as fibromyalgia, endometriosis, ulcerative colitis etc.…”

Section: Individual Preoperative Risk Of Postoperative Painmentioning

confidence: 99%

“…For these reasons, it is particularly prudent to provide optimal analgesia to the ambulatory surgical patient, not only for the case of patient wellbeing but also in order to reduce the incidence of re-admissions and extra healthcare costs [2]. It has been shown that postoperative pain is the most common reason for delayed discharge, unplanned admission and unplanned re-admission after ambulatory surgery [3 ▪ ]…”

Section: Introductionmentioning

confidence: 99%

Pain treatment and prophylaxis on pain

Ræder¹

2022

Current Opinion in Anaesthesiology

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Purpose of reviewAlso in ambulatory surgery, there will usually be a need for analgesic medication to deal with postoperative pain. Even so, a significant proportion of ambulatory surgery patients have unacceptable postoperative pain, and there is a need for better education in how to provide proper prophylaxis and treatment.Recent findingsPostoperative pain should be addressed both pre, intra- and postoperatively. The management should be with a multimodal nonopioid-based procedure specific guideline for the routine cases. In 10–20% of cases, there will be a need to adjust and supplement the basic guideline with extra analgesic measures. This may be because there are contraindications for a drug in the guideline, the procedure is more extensive than usual or the patient has extra risk factors for strong postoperative pain. Opioids should only be used when needed on top of multimodal nonopioid prophylaxis. Opioids should be with nondepot formulations, titrated to effect in the postoperative care unit and eventually continued only when needed for a few days at maximum.SummaryMultimodal analgesia should start pre or per-operatively and include paracetamol, nonsteroidal anti-inflammatory drug (NSAID), dexamethasone (or alternative glucocorticoid) and local anaesthetic wound infiltration, unless contraindicated in the individual case. Paracetamol and NSAID should be continued postoperatively, supplemented with opioid on top as needed. Extra analgesia may be considered when appropriate and needed. First-line options include nerve blocks or interfascial plane blocks and i.v. lidocaine infusion. In addition, gabapentinnoids, dexmedetomidine, ketamine infusion and clonidine may be used, but adverse effects of sedation, dizziness and hypotension must be carefully considered in the ambulatory setting.

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Influencing factors for delayed discharge following day surgery: A retrospective case–control study

Cited by 2 publications

References 25 publications

A Randomized Study on the Prophylactic Use of Acetaminophen to Prevent Fever after the Removal of Drainage Tubes for Lumbar Surgery

A Randomized Study on the Prophylactic Use of Acetaminophen to Prevent Fever after the Removal of Drainage Tubes for Lumbar Surgery

Pain treatment and prophylaxis on pain

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