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Acta Anaesthesiol Scand · Nov 2022
Postoperative pain in a prospectively assessed surgical short-stay cohort: A subgroup analysis.
- Emma Lappalainen, Ulla-Maija Ruohoaho, Hannu Kokki, Sirpa Aaltomaa, Maarit Anttila, Mika Gissler, and Merja Kokki.
- Department of Anaesthesiology and Intensive Care, Kuopio University Hospital, Kuopio, Finland.
- Acta Anaesthesiol Scand. 2022 Nov 1; 66 (10): 119312011193-1201.
BackgroundThere is sparse information about postoperative pain after short stay surgery. We explored the incidence of immediate postoperative pain and its relationship with persistent pain or opioid use 2 weeks after surgery.MethodsThis was a subgroup analysis of prospective and controlled data from adult patients (n = 931) who underwent short-stay surgery in a tertiary care hospital. Data comprised patient demographics, surgical category, pain scores and analgesic management during the recovery unit stay, before discharge on the postoperative morning after surgery and again 2 weeks after surgery.ResultsHalf of the patients had severe dynamic pain in the recovery unit. It was commonest after orthopaedic (70% of patients), followed by gynaecological (54%), gastrointestinal (51%) and spine surgery (49%). Multimodal pain management was used for most patients (n = 811, 87%) with opioid use predominant. The median oxycodone dose during short-stay was the highest after orthopaedic surgery (39 mg). The first individual dynamic pain score after surgery was associated with follow-up pain score at rest (OR = 1.37), dynamic pain (OR = 1.35) and pain interference (OR = 1.34) at 2 weeks after surgery. Maximum dynamic pain reported in the recovery unit was associated with pain at rest (OR = 1.56), dynamic pain (OR = 1.65) and pain interference (OR = 1.45) at 2 weeks after surgery. Pain scores at 2 weeks were highest and analgesic use greatest in those patients who underwent spinal surgery.ConclusionsIntense postoperative pain remains common after short-stay surgery in some surgical categories including orthopaedic surgery and is associated with a greater likelihood of pain at 2 weeks.© 2022 Acta Anaesthesiologica Scandinavica Foundation.
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