• Hans-Fritz Gramke, Janneke M de Rijke, van KleefMaartenM, Freya Raps, Alfons G H Kessels, Madelon L Peters, Michael Sommer, and Marco A E Marcus.
• Department of Anesthesiology and Pain Therapy, University Hospital Maastricht, Maastricht, The Netherlands. hgra@sane.azm.nl
• Clin J Pain. 2007 Jul 1; 23 (6): 543-8.

ObjectivesAlthough a great variety of surgical procedures are performed on an ambulatory basis, little is known about postoperative pain experience at home after ambulatory surgery. This study was performed to assess the prevalence and course of postoperative pain in the early postoperative period after ambulatory surgery.MethodsOver a period of 4 months, 648 patients who underwent day-case surgery were included in our study. Data were collected with interviews and questionnaires. Pain intensity was measured using a visual analog scale (VAS) during 4 days after surgery. Side effects of anesthesia and analgesia techniques were also recorded.ResultsOn the day of the operation, 26% of the patients had moderate to severe pain (defined as mean VAS >40 mm). Mean VAS-scores were greater than 40 mm in 21% on postoperative day (POD) 1, in 13% on POD 2, in 10% on POD 3, and in 9% on POD 4. Operations of nose and pharynx, abdominal operations, plastic surgery of the breasts, and orthopedic operations were the most painful procedures during the first 48 hours.DiscussionThis study showed that an important number of patients still experience moderate to severe pain in the postoperative period after day-case surgery even after a 4-day period. Furthermore, the type of operation should be considered when planning postoperative analgesia for ambulatory surgery.

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