Survey of postoperative analgesia following ambulatory surgery

Rawal, Narinder; Hylander, J; Nydahl, Per-Anders; Olofsson, Ingrid; Gupta, Anil

doi:10.1111/j.1399-6576.1997.tb04829.x

Cited by 227 publications

(126 citation statements)

References 13 publications

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“…Moderate to severe pain was reported in more than 50% of patients who underwent shoulder arthroscopies, elbow/hand procedures, ankle procedures, and knee arthroscopies [19]. Rawal et al [18] substantiated these finding by conducting a prospective study in patients who underwent ambulatory orthopaedic and hand surgeries and found that 41% of patients undergoing orthopaedic surgery and 37% of patients undergoing hand surgery experienced moderate to severe pain. McGarth et al [15] found that about 12% of patients with moderate to severe pain reported not receiving adequate instructions regarding prescribed analgesics and 14% of them reported receiving inadequate information on adjusting their analgesic regimen despite receiving verbal and printed discharge instructions regarding pain management.…”

Section: Discussionmentioning

confidence: 66%

Burden Incurred by Patients and Their Caregivers After Outpatient Surgery: A Prospective Observational Study

Manohar

Cheung

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Introduction The burden of patients and their caregivers after outpatient surgery has not been fully examined. The number of outpatient surgeries has dramatically increased in the last several years, particularly in the orthopaedic sector. Patients undergoing outpatient orthopaedic procedures may be expected to have more postdischarge pain than those undergoing nonorthopaedic outpatient procedures. In light of this, assessment of patient and caregiver expectations and actual burden after discharge is of importance. Questions/purposes We assessed the impact of outpatient surgery on recovery of patients and their caregivers in the postoperative period by determining (1) expected versus actual time to resume daily activities, including work; (2) expected versus actual recovery at 7 and 30 days postoperatively; and (3) the number of caregivers that felt emotional or physical disturbances from caring for outpatients. Methods Forty-four adult patients undergoing outpatient surgical procedures and their primary caregivers were enrolled in this prospective survey study, of which 30% were orthopaedic patients. Surveys assessing postoperative recovery were given to patients at six time points, on Postoperative Days 0 to 3, 7, and 30. Surveys assessing the burden of informal caregiving were given to each patient's primary caregiver at four time points, on Postoperative Days 1 to 3 and 7. The enrollment rate was 79% (44 enrolled of 56 approached) and the survey response rate was 100% for patients and 93% (41 of 44) for caregivers. Results We found that 16 of 44 patients (36%) needed more time than originally anticipated to resume their daily activities and three of 29 patients (10%) needed more time off from work than originally anticipated. Patients were approximately 66% and 88% fully recovered 7 and 30 days after surgery, respectively. The primary caregivers noted disturbances in emotional (nine of 43, 21%) and physical (17 of 43, 40%) aspects of their daily lives while providing care for patients. Our surveyed patients were from multiple surgical services; however, our results may be generalized to an orthopaedic population, although they may underestimate actual results for this population given their generally higher pain scores. Conclusions Patients may take longer to recover from outpatient surgery than previously recognized. As increased pain and prolonged recovery may be associated with increased caregiver burden, these data are of particular significance to the outpatient orthopaedic surgical population. Informal caregiving after outpatient surgery may be an unrecognized physical and psychologic burden and may have a significant societal impact.One or more of the authors (CLW) certifies that he or she received, during the study period, funding from the

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Section: Discussionmentioning

confidence: 66%

Burden Incurred by Patients and Their Caregivers After Outpatient Surgery: A Prospective Observational Study

Manohar

Cheung

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…It is estimated that up to 30-40% of ambulatory surgical patients suffer from moderate to severe pain during the first 24-48 hours after their discharge 2 , which often times will interfere with sleep and daily functioning. Even though this improves with time, postoperative pain remains the most common reason for recurrent general practitioner office visits and unanticipated hospital admission [6][7][8] . This becomes especially important in hand patients.…”

Section: As Of 2003 70% Of the Surgical Procedures In Northmentioning

confidence: 99%

Pain Management Strategies in Hand Surgery

Ketonis

Ilyas

Liss

2015

Orthopedic Clinics of North America

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“…1,2,5,6 Incisional LA analgesia has been shown to diminish the need for opioids. However, these are all single dose studies.…”

Section: Méthodementioning

confidence: 99%

“…R Re es su ul lt ts s: : During the first 24 hr, median number of LA applications in 26 B patients was 4 (range [1][2][3][4][5][6] and in 25 R patients 3 (range [1][2][3][4][5]. Both groups showed low VAS pain scores: less than 2 at rest, less than 4 with movement.…”

mentioning

confidence: 99%

“…C Co on nc cl lu us si io on n: : Self-administration of the LA solution via a catheter in the surgical wound is an effective method of pain relief after IHR with little side-effects. [1][2][3][4] Postoperative pain is often treated with less potent opiods, non-steroidal anti-inflammatory drugs (NSAIDs) and/or paracetamol given by the oral or im route, but these methods are not always effective. Intravenous analgesia is predictable and effective but demands well defined safety measures and cannot be administered at home after day surgery.…”

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confidence: 99%

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