Preoperative analgesic instruction and prescription reduces early home pain after outpatient surgery: a randomized controlled trial.
Jean Selim, Zoubir Djerada, Céline Chaventre, Thomas Clavier, Bertrand Dureuil, Emmanuel Besnier, Vincent Compere
Author Information
Jean Selim: Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France. jean.selim@chu-rouen.fr. ORCID
Zoubir Djerada: Department of Pharmacology, EA3801, SFR CAP-Santé, Reims University Hospital, 51 rue Cognacq-Jay, 51095, Reims, France.
Céline Chaventre: Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
Thomas Clavier: Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
Bertrand Dureuil: Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
Emmanuel Besnier: Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
Vincent Compere: Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.
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.
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