A survey of pain and other symptoms that affect the recovery process after discharge from an ambulatory surgery unit

Abstract

Study objective: To determine the significance of pain and other symptoms on the recovery process after ambulatory surgery, by surveying pain, analgesic use, and related aspects of recovery in the first 48 hours after discharge from an ambulatory surgery unit.

Design: Prospective, observational, surveillance survey.

Patients: A total of 175 patients were studied, 25 in each of 6 surgical groups including knee arthroscopy, hernia repair, pelvic laparoscopy, transvaginal surgery, surgery for breast disease, and plastic surgery.

Interventions: Patients were treated in a manner considered normal or "usual" for the surgeon and the institution.

Measurements: Pain scores (0 to 10), analgesic use, symptom frequency, symptom distress scores, activity level (% of normal), and satisfaction scores were obtained by telephone interview 24 and 48 hours after discharge. Group means (+/-SE), proportions and correlations between predictor variables were determined in relevant groups.

Main results: The response rate to postoperative telephone calls was 89% at 24 hours, and 82% at 48 hours. At 24 hours, maximum pain was >3/10 in 60%, or >7/10 in 20% of patients. Pain prevented or disrupted sleep in 46% of patients. Activity level was reduced to 33% of normal at 24 hours; pain was reported as the primary or secondary reason for limiting activity by 54% of patients. At 24 hours, average pain scores correlated inversely with activity (r = -0.49, p = or < 0.0001); least pain score correlated best with satisfaction (r = 0.03, p = 0.0005).

Conclusions: Improvements in pain therapy after discharge appear warranted to provide more consistent pain relief, and hasten return to normal activity.