Gramke Hans-Fritz, de Rijke Janneke M, van Kleef Maarten, Raps Freya, Kessels Alfons G H, Peters Madelon L, Sommer Michael, Marcus Marco A E
Department of Anesthesiology and Pain Therapy, University Hospital Maastricht, Maastricht, The Netherlands.
Clin J Pain. 2007 Jul-Aug;23(6):543-8. doi: 10.1097/AJP.0b013e318074c970.
Although a great variety of surgical procedures are performed on an ambulatory basis, little is known about postoperative pain experience at home after ambulatory surgery. This study was performed to assess the prevalence and course of postoperative pain in the early postoperative period after ambulatory surgery.
Over a period of 4 months, 648 patients who underwent day-case surgery were included in our study. Data were collected with interviews and questionnaires. Pain intensity was measured using a visual analog scale (VAS) during 4 days after surgery. Side effects of anesthesia and analgesia techniques were also recorded.
On the day of the operation, 26% of the patients had moderate to severe pain (defined as mean VAS >40 mm). Mean VAS-scores were greater than 40 mm in 21% on postoperative day (POD) 1, in 13% on POD 2, in 10% on POD 3, and in 9% on POD 4. Operations of nose and pharynx, abdominal operations, plastic surgery of the breasts, and orthopedic operations were the most painful procedures during the first 48 hours.
This study showed that an important number of patients still experience moderate to severe pain in the postoperative period after day-case surgery even after a 4-day period. Furthermore, the type of operation should be considered when planning postoperative analgesia for ambulatory surgery.
尽管各种各样的外科手术都在门诊进行,但对于门诊手术后患者在家中的疼痛体验却知之甚少。本研究旨在评估门诊手术后早期术后疼痛的发生率及发展过程。
在4个月的时间里,648例行日间手术的患者纳入我们的研究。通过访谈和问卷收集数据。术后4天内使用视觉模拟评分法(VAS)测量疼痛强度。同时记录麻醉和镇痛技术的副作用。
手术当天,26%的患者有中度至重度疼痛(定义为平均VAS>40 mm)。术后第1天(POD 1)21%的患者平均VAS评分大于40 mm,POD 2为13%,POD 3为10%,POD 4为9%。鼻咽喉手术、腹部手术、乳房整形手术和骨科手术是术后48小时内最疼痛的手术。
本研究表明,即使在术后4天,仍有相当数量的患者在日间手术后的术后期间经历中度至重度疼痛。此外,在为门诊手术计划术后镇痛时应考虑手术类型。