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Pain evaluation after day-surgery using a mobile phone application. Anaesth Crit Care Pain Med 2021; 40:100879. [PMID: 33965646 DOI: 10.1016/j.accpm.2021.100879] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Revised: 03/04/2021] [Accepted: 03/04/2021] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Few studies assess postoperative outcomes after discharge in the ambulatory setting. The aim of this study was to investigate postoperative pain and adverse effects at 24 h and at 7 days after day surgery using an e-health follow-up smartphone-based application named SATELIA®. MATERIALS AND METHODS This retrospective, observational and monocentric cohort study was conducted at the University Hospital of Bordeaux. All eligible patients for SATELIA® follow-up between May 2018 and June 2019 were screened for the analysis. Data were extracted from two databases. Those with a missing primary outcome were excluded from the analysis. The main outcome was the worst pain score on POD 1, self-reported via SATELIA®. The secondary outcomes were the incidence of adverse effects on POD1, as well as the worst pain score and adverse effects on POD7. Quantitative data were reported by the median (IQR) and categorical data were presented as absolute numbers (%). RESULTS A total of 2283 patients were screened for analysis, from which 592 were excluded due to missing data for the main outcome; 1691 patients were thus finally included. The median worst pain score at POD 1 was 3.0 (1.0-5.0); 35.5% (n = 601/1691) and 29.1% (n = 492/1691) of the patients reported moderate-to-severe pain at POD1 and POD7, respectively. CONCLUSION This retrospective study shows that 35.5% of patients experience moderate-to-severe pain after day surgery. Even if SATELIA® should be further developed and evaluated, it also demonstrates the interest of using phone based software to follow patients after discharge and ensure a better personalised management.
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Dziadzko M, Aubrun F. Management of postdischarge nausea and vomiting. Best Pract Res Clin Anaesthesiol 2020; 34:771-778. [PMID: 33288126 DOI: 10.1016/j.bpa.2020.10.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 10/14/2020] [Accepted: 10/26/2020] [Indexed: 11/27/2022]
Abstract
Postdischarge nausea and vomiting (PDNV) occurs in at least 30% of patients leaving hospital, especially after day-case surgery. A significant number of ambulatory patients may develop PDNV associated with the use of analgesics for postsurgical pain. A validated PDNV prediction score and international evidence-based consensus guidelines for PONV/PDNV management are available. High-risk patients benefit from a predischarge PDNV risk assessment and the use of adapted pharmacological intervention (combination of long- and short-acting antiemetics and access to antiemetics at home). Patient education is often overlooked in this context. All clinicians involved in the ambulatory surgery care process should participate in the development of institutional protocol for PONV/PDNV management. Constant quality control and patients' feedback should be integrated as part of an efficient implementation strategy.
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Affiliation(s)
- Mikhail Dziadzko
- Service Anesthésie Réanimation Douleur, Université Lyon 1, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, 69317 LYON Cédex 04, France.
| | - Frédéric Aubrun
- Service Anesthésie Réanimation Douleur, Université Lyon 1, Hospices Civils de Lyon, Hôpital de la Croix-Rousse, 103 Grande Rue de la Croix-Rousse, 69317 LYON Cédex 04, France.
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Odom-Forren J. Measurement of Postdischarge Nausea and Vomiting for Ambulatory Surgery Patients: A Critical Review and Analysis. J Perianesth Nurs 2011; 26:372-83. [DOI: 10.1016/j.jopan.2011.09.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2011] [Revised: 08/19/2011] [Accepted: 09/14/2011] [Indexed: 02/08/2023]
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Rosén HI, Bergh IH, Odén A, Mårtensson LB. Patients´ experiences of pain following day surgery - at 48 hours, seven days and three months. Open Nurs J 2011; 5:52-9. [PMID: 21769308 PMCID: PMC3137156 DOI: 10.2174/1874434601105010052] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2011] [Revised: 05/11/2011] [Accepted: 05/12/2011] [Indexed: 11/22/2022] Open
Abstract
Recent studies indicate that patients experience pain after day surgery for a longer period than previously known. This requires verification. This was a prospective, descriptive correlational study. A convenience sample of 298 day surgery patients undergoing various surgical procedures was asked to report pain intensity and its interference with daily function 48 hours, seven days and three months after day surgery. Correlation and regression analyses were performed. On a NRS, 55% (n=230) reported pain (≥4) 48 hours after surgery, as did 43% (n=213) at seven days. Pain interfered with normal activities at ≥4 NRS at 48 hours and at seven days, after which it decreased.
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Affiliation(s)
- Helena Inger Rosén
- School of Life Sciences, University of Skövde, Box 408, Skövde, (SE-541 28), Sweden
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Abstract
AIM This paper reports a literature review to synthesize the evidence on day surgery, demonstrating its usefulness for innovative nurses. BACKGROUND Day surgery growth has developed rapidly in recent years. Such a rapid growth has triggered a shift in nursing roles and interventions. Nursing roles are taking shape within modern day surgical units but have not been widely reviewed in developing countries. METHODS The RCN library, BNI, CINAHL and Medline databases were searched using the terms 'day surgery and technological advantages', 'financial/economic benefits', 'patient experiences/satisfaction', 'day surgery/international comparisons', 'day surgery and developing countries'. Only papers in the English language from 1990 to 2005 were reviewed, with a predominantly adult focus. The papers examined mainly used research techniques and some opinion papers, policy documents and textbooks were examined for additional information. FINDINGS The key strengths of day surgery are cost-effectiveness, increased patient satisfaction and low infection rates. Patients indicated that effective information provision and psychological preparation helped them cope with the experience. The use of music, story telling and distraction reduced pre-operative anxiety. Contrastingly, the deficits included poor information giving and psychological preparation resulting in high anxiety levels. Many patients encountered variable pain and nausea management and education strategies. CONCLUSION This review highlights the importance of adequate preparation and continuous psychological support for patients undergoing day surgery. The challenges faced by practitioners involved with innovation are also emphasized.
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Affiliation(s)
- J Gilmartin
- School of Healthcare Studies, Baines Wing, University of Leeds, Leeds, UK.
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Shah A, Nielsen KC, Braga L, Pietrobon R, Klein SM, Steele SM. Interscalene brachial plexus block for outpatient shoulder arthroplasty: Postoperative analgesia, patient satisfaction and complications. Indian J Orthop 2007; 41:230-6. [PMID: 21139750 PMCID: PMC2989124 DOI: 10.4103/0019-5413.33688] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Shoulder arthroplasty procedures are seldom performed on an ambulatory basis. Our objective was to examine postoperative analgesia, nausea and vomiting, patient satisfaction and complications of ambulatory shoulder arthroplasty performed using interscalene brachial plexus block (ISB). MATERIALS AND METHODS We prospectively examined 82 consecutive patients undergoing total and hemi-shoulder arthroplasty under ISB. Eighty-nine per cent (n=73) of patients received a continuous ISB; 11% (n=9) received a single-injection ISB. The blocks were performed using a nerve stimulator technique. Thirty to 40 mL of 0.5% ropivacaine with 1:400,000 epinephrine was injected perineurally after appropriate muscle twitches were elicited at a current of less than 0.5% mA. Data were collected in the preoperative holding area, intraoperatively and postoperatively including the postanesthesia care unit (PACU), at 24h and at seven days. RESULTS Mean postoperative pain scores at rest were 0.8 ± 2.3 in PACU (with movement, 0.9 ± 2.5), 2.5 ± 3.1 at 24h and 2.8 ± 2.1 at seven days. Mean postoperative nausea and vomiting (PONV) scores were 0.2 ± 1.2 in the PACU and 0.4 ± 1.4 at 24h. Satisfaction scores were 4.8 ± 0.6 and 4.8 ± 0.7, respectively, at 24h and seven days. Minimal complications were noted postoperatively at 30 days. CONCLUSIONS Regional anesthesia offers sufficient analgesia during the hospital stay for shoulder arthroplasty procedures while adhering to high patient comfort and satisfaction, with low complications.
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Affiliation(s)
- Anand Shah
- School of Medicine, University of Pennsylvania, Philadelphia, PA, USA,Correspondence: Dr. Anand Shah, School of Medicine, University of Pennsylvania, 3450 Hamilton Walk, Suite 100, Philadelphia, PA, USA 19104. E-mail:
| | - Karen C Nielsen
- The Center for Excellence in Surgical Outcomes, University of Nebraska Medical Center, Omaha, NE,The Division of Ambulatory Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Larissa Braga
- The Center for Excellence in Surgical Outcomes, University of Nebraska Medical Center, Omaha, NE
| | - Ricardo Pietrobon
- The Center for Excellence in Surgical Outcomes, University of Nebraska Medical Center, Omaha, NE,The Division of Ambulatory Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA,The Division of Orthopedic Surgery, Department of Surgery, Duke University Medical Center, Durham, North Carolina, USA
| | - Stephen M Klein
- The Center for Excellence in Surgical Outcomes, University of Nebraska Medical Center, Omaha, NE,The Division of Ambulatory Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
| | - Susan M Steele
- The Center for Excellence in Surgical Outcomes, University of Nebraska Medical Center, Omaha, NE,The Division of Ambulatory Anesthesia, Department of Anesthesiology, Duke University Medical Center, Durham, North Carolina, USA
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Don’t Use Thiopental to Decrease Propofol Injection Pain: In Response. Anesth Analg 2004. [DOI: 10.1097/00000539-200409000-00070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Lacy T, Connelly NR, Freeman K. Don’t Use Thiopental to Decrease Propofol Injection Pain. Anesth Analg 2004; 99:953. [PMID: 15333446 DOI: 10.1213/01.ane.0000131688.18641.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- Timothy Lacy
- Department of Anesthesiology, Baystate Medical Center Director of Anesthesia Research, Baystate Medical Center, Associate Professor of Anesthesiology, Tufts University School of Medicine Department of Anesthesiology, Baystate Medical Center, Assistant Professor of Anesthesiology, Tufts University School of Medicine, Springfield, MA
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Abstract
Medical advances have led to a considerable rise in the level of elective surgery undertaken as day-case surgery and with minimal hospital stay. However, amid such advances, preoperative psychological care has remained relatively static. A considerable number of patients are very anxious prior to elective surgery and little formal care is undertaken to address this major issue. A review of the literature from 1990 to 2002 was therefore undertaken in order to assess the present level of knowledge and interventions concerning patient anxiety when undergoing modern, intermediate surgical intervention. Thirty-four studies embracing data from 3754 patients undergoing both inpatient and day-case procedures were reviewed. Three main themes emerged - causes of anxiety, clinical concerns and measurement, and anxiety management. Each theme is discussed alongside details extracted from the relevant studies. Finally, the main issues arising are summarized and future research challenges identified.
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Affiliation(s)
- Mark Mitchell
- School of Nursing, University of Salford, Manchester, UK.
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Marley RA, Swanson J. Patient care after discharge from the ambulatory surgical center. J Perianesth Nurs 2001; 16:399-417; quiz 417-9. [PMID: 11740781 DOI: 10.1053/jpan.2001.28891] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
UNLABELLED An important and often forgotten aspect of postoperative care occurs after the patient is discharged from the ambulatory surgical center. With more than 60% of all surgeries and procedures occurring on an ambulatory basis, what happens after the patient is no longer in continuous professional care is of concern to the ambulatory nurse. Numerous physical postoperative complaints are common and expected sequelae of anesthesia and surgery in the ambulatory patient. In this article, important postdischarge complications are reviewed and contemporary management options discussed. The information contained in this review article is valuable to the provider in educating patients regarding their anticipated course of postoperative recovery. OBJECTIVES -Based on the content of this article, the reader should be able to (1) identify important postdischarge complications to provide patients with comprehensive discharge instructions regarding their continued recovery at home; (2) discuss contemporary management options available to treat postdischarge complications; (3) realize the incidence of specific postdischarge complications and how that relates to patient satisfaction with the surgical experience; (4) recognize signs and symptoms of postdischarge complications; and (5) identify risk factors of patients for developing specific complications in the postoperative phase.
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Affiliation(s)
- R A Marley
- Chief Nurse Anesthetist for Northern Colorado Anesthesia Professional Consultants, and Jan Swanson, Poudre Valley Hospital, Fort Collins, CO 80524, USA
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