El-Tallawy Salah N, Alsubaie Abdullah T, Yousef Elsayed A, Dahum Fahriziya T, Abdelzaher Tarek A, Ahmed Rania S, Alcudia Vanessa M, Badawy Walid R, De Vera Sheryll A, Nagiub Mohamed S, Aljumah Amal R, Manaa Essam M, Ali Wegdan A
Anesthesia and Pain Management, King Abdulaziz University Hospital, College of Medicine, King Saud University, Riyadh, SAU.
Anesthesia and Pain Management, Faculty of Medicine, National Cancer Institute (NCI) Cairo University, Cairo, EGY.
Cureus. 2025 Jun 16;17(6):e86118. doi: 10.7759/cureus.86118. eCollection 2025 Jun.
Background Effective management of postoperative pain in the day surgery unit (DSU) is crucial to ensure patient safety and improve satisfaction. The management of postoperative pain in the DSU is challenging due to short hospital stays, variability in the procedures, and physician practices. This study aims to identify factors linked to severe postoperative pain and patient satisfaction levels in the DSU to improve pain management and patient outcomes. Methodology This multicenter prospective observational study included 395 patients undergoing different same-day surgical procedures under general anesthesia (GA), regional anesthesia (RA), or combined anesthesia (GA+RA). Data included baseline patient characteristics, anesthetic technique, surgical procedure, interventions like local anesthetic infiltrations, patient education, and pain outcomes. Postoperative pain assessment was done using the Numerical Rating Scale (NRS). Statistical analysis was done to identify the pain outcomes, correlations, and predictors of severe pain and satisfaction. Severe pain is recognized as a pain score (>7/10) by NRS. Results The study included 395 patients undergoing different surgical procedures, including Orthopedic (Ortho), obstetrics/gynecology (Ob/Gyn), general surgery (GS), bariatric, urology, and plastic surgeries. Key factors linked to severe postoperative pain included female gender, presence of preoperative pain, and lack of local anesthetic (LA) infiltration. Women experienced more severe pain than men did (55.4% vs. 44.6%). At the same time, men experienced relatively higher satisfaction than women did (6.1 vs. 5.68). LA infiltration reduced worst pain scores (from 6.39 to 5.68) and improved satisfaction (from 5.21 to 6.11). Preoperative education on postoperative pain and pain relief methods reduced worst pain scores (from 6.14 to 5.66) and improved satisfaction (from 5.53 to 6.13). Combined GA+RA provided better pain outcomes than GA or RA alone. Regarding the surgical procedures, Ortho and Ob/Gyn surgeries had the highest incidence of severe pain (40.7% and 40.5%), while urology and plastic surgery patients reported higher satisfaction scores. Conclusions Severe postoperative pain in DSU is influenced by gender, preoperative pain, and type of anesthesia. Some interventions, such as LA infiltration, preoperative education, and combined GA+RA, significantly improved pain outcomes and satisfaction. Strategies like procedure-specific postoperative pain management are recommended to enhance pain outcomes and patient satisfaction.
日间手术单元(DSU)中术后疼痛的有效管理对于确保患者安全和提高满意度至关重要。由于住院时间短、手术的可变性以及医生的操作,DSU中术后疼痛的管理具有挑战性。本研究旨在确定与DSU中严重术后疼痛和患者满意度水平相关的因素,以改善疼痛管理和患者预后。
这项多中心前瞻性观察性研究纳入了395例接受全身麻醉(GA)、区域麻醉(RA)或联合麻醉(GA+RA)下不同同日手术的患者。数据包括患者基线特征、麻醉技术、手术、局部麻醉浸润等干预措施、患者教育以及疼痛结局。使用数字评分量表(NRS)进行术后疼痛评估。进行统计分析以确定疼痛结局、相关性以及严重疼痛和满意度的预测因素。严重疼痛被定义为NRS评分>7/10。
该研究纳入了395例接受不同手术的患者,包括骨科、妇产科、普通外科、减肥手术、泌尿外科和整形外科手术。与严重术后疼痛相关的关键因素包括女性性别、术前疼痛的存在以及缺乏局部麻醉(LA)浸润。女性比男性经历更严重的疼痛(55.4%对44.6%)。同时,男性的满意度相对高于女性(6.1对5.68)。LA浸润降低了最严重疼痛评分(从6.39降至5.68)并提高了满意度(从5.21升至6.11)。术前关于术后疼痛和疼痛缓解方法的教育降低了最严重疼痛评分(从6.14降至5.66)并提高了满意度(从5.53升至6.13)。联合GA+RA比单独使用GA或RA提供了更好的疼痛结局。关于手术,骨科和妇产科手术的严重疼痛发生率最高(40.7%和40.5%),而泌尿外科和整形外科患者报告的满意度得分更高。
DSU中严重术后疼痛受性别、术前疼痛和麻醉类型影响。一些干预措施,如LA浸润、术前教育和联合GA+RA,显著改善了疼痛结局和满意度。建议采用特定手术的术后疼痛管理等策略来提高疼痛结局和患者满意度。