Postoperative analgesia and discharge criteria for day surgery

Knottenbelt, Graham; van der Westhuizen, Joreline; Griffith, Nia

doi:10.1016/j.mpaic.2007.01.003

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Volume 8, Issue 3 , Pages 122-125, March 2007

Postoperative analgesia and discharge criteria for day surgery

Graham Knottenbelt, FRCA, is fourth-year Registrar in Anaesthesia on the North Bristol rotation. He qualified at the University of the Witwatersrand, South Africa

Joreline van der Westhuizen, FARSCI, is Specialist Registrar in Anaesthesia on the North Bristol rotation. She qualified at the University of the Orange Free State, South Africa

Nia Griffith, FRCA, is Consultant Anaesthetist at Southmead Hospital, part of North Bristol NHS Trust. She qualified from the University of Wales College of Medicine, Cardiff and trained in anaesthesia in Northampton, Oxford, Reading and Lyon, France. Her main interests are day surgery and regional anaesthesia

Abstract

After day surgery, patients are discharged within a relatively short time. A meticulous and safe anaesthetic technique, which enables a good-quality recovery with minimal postoperative morbidity, is required. The provision of adequate analgesia from the time of operation and the following few days is paramount for patient satisfaction. Multimodal analgesia using regular paracetamol and non-steroidal anti-inflammatory drugs, with local anaesthesia where appropriate and weak opioids for breakthrough pain, is ideal. Postoperative nausea and vomiting should be minimized by adequate hydration and avoiding long-acting opioids. Discharge criteria must be robust, although the requirement for oral intake and voiding before discharge in low-risk patients is currently being questioned. Patients must be given adequate verbal and written instructions on pain relief and possible complications before discharge.

Keywords: ambulatory surgery, analgesics, day surgery, discharge criteria, postoperative nausea and vomiting