Kavanagh T, Hu P, Minogue S
Department of Anaesthesia, Intensive Care and Pain Medicine, Adelaide and Meath Hospital, Incorporating the National Children's Hospital, Belgard Road, Tallaght, Dublin 22, Ireland.
Ir J Med Sci. 2008 Jun;177(2):111-5. doi: 10.1007/s11845-008-0131-5. Epub 2008 Feb 13.
Laparoscopic cholecystectomy has been performed as a day-case procedure for over a decade. This procedure can be associated with a high incidence of pain and post-operative nausea and vomiting (PONV). There is a paucity of information regarding the post-discharge care of these patients.
To determine the effectiveness and adequacy of take-home analgesic packs given to patients undergoing ambulatory surgery.
A prospective study of 40 patients undergoing laparoscopic cholecystectomy to evaluate post-operative pain, analgesia requirements and PONV following discharge. Data regarding unplanned admissions, patient satisfaction and GP attendance rates were also recorded.
At 24 h, 65% of patients reported moderate pain, 23% severe pain and 25% of patients reported PONV. The rate of GP attendance for further analgesia or antiemetics was 12.5%. Unexpected admission rate was 10%.
The incidence of PONV post-discharge suggests that adding an antiemetic to our take-home analgesic packs may improve patient comfort. The 2-day supply of diclofenac and co-codamol could also be extended as 65% of patients had moderate to severe pain. The information gathered shows the importance of post-discharge follow-up of ambulatory surgery patients.
腹腔镜胆囊切除术作为日间手术已开展了十多年。该手术可能伴有较高的疼痛发生率以及术后恶心呕吐（PONV）。关于这些患者出院后护理的信息匮乏。
确定给予接受门诊手术患者的家庭镇痛包的有效性和充分性。
对40例行腹腔镜胆囊切除术的患者进行前瞻性研究，以评估出院后的术后疼痛、镇痛需求和PONV。还记录了关于非计划入院、患者满意度和全科医生就诊率的数据。
24小时时，65%的患者报告中度疼痛，23%报告重度疼痛，25%的患者报告PONV。因进一步镇痛或使用止吐药而就诊全科医生的比例为12.5%。意外入院率为10%。
出院后PONV的发生率表明，在我们的家庭镇痛包中添加止吐药可能会提高患者舒适度。由于65%的患者有中度至重度疼痛，双氯芬酸和可待因复方制剂的2天供应量也可延长。所收集的信息表明了门诊手术患者出院后随访的重要性。
