Jean Selim1,2, Zoubir Djerada3, Céline Chaventre4, Thomas Clavier4,5, Bertrand Dureuil4, Emmanuel Besnier4,5, Vincent Compere4,6. 1. Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France. jean.selim@chu-rouen.fr. 2. Normandy Univ, UNIVROUEN, INSERM U1096, 76000 , Rouen, France. jean.selim@chu-rouen.fr. 3. Department of Pharmacology, EA3801, SFR CAP-Santé, Reims University Hospital, 51 rue Cognacq-Jay, 51095, Reims, France. 4. Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France. 5. Normandy Univ, UNIVROUEN, INSERM U1096, 76000 , Rouen, France. 6. Day Surgery Unit, Rouen University Hospital, 76000, Rouen, France.
Abstract
BACKGROUND: Home pain remains the most common complication in outpatient surgery. Optimal management requires good information and early availability of analgesics. The main objective of this randomized controlled trial was to compare the effects of pre- vs postoperative analgesic instruction and prescription on postoperative home pain. METHODS: Patients were randomized into an anesthesia consultation group (AC group) and a standard postoperative group (POP group). The AC group and the POP group received analgesic prescription and instruction during the anesthesia consultation and after surgery, respectively. The primary outcome was the incidence of home pain on postopertive day one (D1). Home pain was defined by at least one episode with a numeric rating scale score > 3/10 at rest. Treatment compliance and postoperative nausea and vomiting (PONV) were also assessed on D1 and postoperative day 7 (D7). RESULTS: One hundred and eighty-six patients were included between May 2017 and May 2018 at Rouen University Hospital, France. Ninety-four patients were randomized to the AC group and 92 to the POP group. On D1, the incidence of pain was 23/94 (24%) in the AC group and 44/92 (48%) in the POP group (P < 0.001). On D1, the rate of treatment compliance was significantly higher in the AC group than in the POP group (85% vs 69%; P = 0.02). There was no statistically significant difference in the incidence of pain or treatment compliance between groups on D7 or in PONV on D1 and on D7. CONCLUSIONS: Preoperative analgesic instruction and prescription during anesthesia consultation reduces the incidence of early postoperative home pain in outpatient surgery. TRIAL REGISTRATION: www.clinicaltrialsgov (NCT03205189); registered 2 July 2017.
BACKGROUND: Home pain remains the most common complication in outpatient surgery. Optimal management requires good information and early availability of analgesics. The main objective of this randomized controlled trial was to compare the effects of pre- vs postoperative analgesic instruction and prescription on postoperative home pain. METHODS: Patients were randomized into an anesthesia consultation group (AC group) and a standard postoperative group (POP group). The AC group and the POP group received analgesic prescription and instruction during the anesthesia consultation and after surgery, respectively. The primary outcome was the incidence of home pain on postopertive day one (D1). Home pain was defined by at least one episode with a numeric rating scale score > 3/10 at rest. Treatment compliance and postoperative nausea and vomiting (PONV) were also assessed on D1 and postoperative day 7 (D7). RESULTS: One hundred and eighty-six patients were included between May 2017 and May 2018 at Rouen University Hospital, France. Ninety-four patients were randomized to the AC group and 92 to the POP group. On D1, the incidence of pain was 23/94 (24%) in the AC group and 44/92 (48%) in the POP group (P < 0.001). On D1, the rate of treatment compliance was significantly higher in the AC group than in the POP group (85% vs 69%; P = 0.02). There was no statistically significant difference in the incidence of pain or treatment compliance between groups on D7 or in PONV on D1 and on D7. CONCLUSIONS: Preoperative analgesic instruction and prescription during anesthesia consultation reduces the incidence of early postoperative home pain in outpatient surgery. TRIAL REGISTRATION: www.clinicaltrialsgov (NCT03205189); registered 2 July 2017.
Authors: Jean Selim; Marc Selim; Zoé Demailly; Thierry Wable; Thomas Clavier; Emmanuel Besnier; Bertrand Dureuil; Benoît Veber; Zoubir Djerada; Vincent Compere Journal: Front Med (Lausanne) Date: 2022-04-21