The Effects of Preoperative Pain Education on the Decision to Discharge Patients Following Single-Incision Laparoscopic Appendectomy

Abstract

Purpose: Few studies have analyzed the effects of preoperative pain education on the postoperative decision to discharge. The purpose of this study was to determine the effects of pain education and management on the decision to discharge patients after single-incision laparoscopic appendectomy (SILA). Methods:We analyzed 135 patients who had undergone SILA for acute appendicitis between March 2017 and April 2018 in a single medical center. Of these, 72 (53.3%) patients had received preoperative pain education (group I), and 63 (46.7%) patients had not (group 2). We compared perioperative outcomes and complications between the groups.Results: Baseline characteristics of sex, age, body mass index, American Society of Anesthesiologist score, and systemic inflammation factors (neutrophil-lymphocyte ratio, C-reactive protein level) did not differ significantly between the groups. There were no postoperative complications for patients in either group. Perioperative consequences and pathologic findings were not significantly different between the groups; however, length of hospital was significantly shorter in group 1. Conclusion:Preoperative pain education in relation to postoperative pain management influenced the decision to shorten the postoperative hospital length of stay after SILA.

Comparing the Postoperative Outcomes of Single-Incision Laparoscopic Appendectomy and Three Port Appendectomy With Enhanced Recovery After Surgery Protocol for Acute Appendicitis: A Propensity Score Matching Analysis

“…The surgeries for patients with complicated appendicitis showing evidence of perforation and gangrenous appendixes in our study were more frequently performed in another worldwide study (perforation: 25 of 101, 24.8% vs. 255 of 3,631, 7.0%) [24]. As our institution is a tertiary referral medical center, patients with simple appendicitis are often transferred to a local clinic when ever there is shortage of surgeons or anesthetists [22]. However, patients with severe appendicitis, such as perforated appendicitis, are likely to undergo surgery at our hospital.…”

“…Our ERAS program for patients included the preoperative pain education, effective pain control, opioid minimization, and early diet. Due to the diagnosis-related group (DRG) systems for patients undergoing appendectomy, some patients decline postoperatively to be discharged from the hospital until complete recovery; however, preoperative pain education has shortened the length of hospital stay after surgery [22].…”

“…The surgeon provided pain education to the patients including information concerning pain severity and type and a pain control plan. The patients were informed of the discharge criteria and the methods to control pain postoperatively, such as oral or intravenous medications as described previously [22]. Patients received preoperative treatment with intravenous opioid-sparing analgesia (acetaminophen 1 g and ketolac 30 mg).…”

“…All operations were performed by specialized colorectal surgeons with experience performing more than 100 SILA cases. SILA is performed according to the maneuver previously described [22]. Briefly, transumbilical access was created with open access.…”

Relationship Between Appendectomy Incidence and Computed Tomography Scans Based on Korean Nationwide Data, 2003–2017

“… 18 In addition, development of multimodal pain managements, such as rectus sheath block and preoperative pain education, can contribute to the reduction in LOH. 19 20 In a recently conducted randomized clinical trial, it was demonstrated that enhanced recovery after surgery program can be applied in the field of laparoscopic appendectomy. In this program, patients advanced to their regular diet in 6 hours after surgery.…”