Postoperative pain management on discharge after day case gynaecologic laparoscopy

Abstract

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.