SUMMARYThe efficacy of Entonox as a supplement to local anaesthesia for minor surgical procedures was studied. Eighty-five patients undergoing surgery for the incision and drainage of a subcutaneous abscess using a local anaesthetic were involved in a trial to ascertain the level of pain associated with such procedures and to investigate the possibility of using on-demand Entonox to supplement the local anaesthesia provided. Patients received either the standard local anaesthesia, or, alternatively, the local anaesthesia was supplemented with oxygen or Entonox via on-demand apparatus.Patients indicated on three linear visual analogue scales their pain, anxiety and total discomfort, and also on a cartoon pain rating scale, at different stages during the operation.Results showed that there was no statistically significant reduction in pain provided by the Entonox, despite general patient approval. Both oxygen and Entonox showed some anxiolytic properties. Pure oxygen was also seen to produce a rise in heart rate, while both gases (pure oxygen and Entonox) caused an increase in diastolic blood pressure. It was also seen that the patient's short term memory of the pain experienced was unaffected by pure oxygen or Entonox.

Previous review in the study hospital showed that the pain management following discharge from the Day Surgery Unit (DSU) was inadequate with 6% of patients discharged home with pain medicines. The aim of this audit was to assess the efficacy of the new DSU discharge medication system for patients following day laparoscopy procedures. Pain control following the procedure and patient satisfaction with pain management were also assessed. A total of 100 patients who underwent a day case laparoscopy procedure at the study hospital from 12 June 2018 to 23 April 2019 were included in the study. Patient medical records, anaesthetic and recovery charts were reviewed. Analgesic requirements and pain scores in theatre, recovery, DSU and on discharge were documented. Patients were followed-up by phone interview on analgesic use in the 24 h post discharge, and on patient satisfaction with postoperative pain management. At discharge from the DSU, 88 (88%) patients were supplied analgesics and medicine information leaflets. In the 24 h postoperative phone follow-up, 63 (78.7%) patients indicated they were not in severe pain. Of the 53 patients who reported moderate (n = 36) to severe (n = 17) pain, 47 (88.7%) used analgesics at home. The common analgesics used after discharge were paracetamol (68.8%), tramadol (51.3%), ibuprofen (40%) and celecoxib (25%), Patient satisfaction with pain management in the 24 h post discharge was (69) 86.3%. The new discharge process has improved the supply of analgesic medication and medication information for patients following a day laparoscopy procedure. Patients reported great satisfaction with pain management in the hospital.