[Postoperative pain and surgical treatment of trapeziometacarpal osteoarthritis of the thumb after ambulatory surgery].
OBJECTIVE
The course of pain and the incidence of the side effects from analgesics were evaluated for 15 days in 26 consecutive outpatients who underwent a surgical cure of trapeziometacarpal osteoarthritis of the thumb under regional block.


METHODS
Prospective study.


METHODS
The analgesic regimen prescribed at discharge consisted on a regular administration of a combination of ketoprofen (50 mg.6.h-1) plus the association of acetaminophen and propoxyphene (two tablets.6.h-1). Patients were asked to evaluate their pain using a numerical rating scale graduated from 0 to 10. Data were collected during a telephone interview at day 4, 8 and 15.


RESULTS
Overall, patients scrupulously followed the medical prescription. At day four, 80% of patients still needed analgesics. The mean period during which NSAID, acetaminophen and propoxyphene were maintained was 4 and 6 days respectively. Fifty percent of patients reported severe pain during postoperative day 1 and 2. Moderate pain was reported at day 3 and 4 in respectively 54% and 42% of cases. Beyond this period, most patients indicated pain of weak intensity (71% at day 8). Epigastric pain has been noticed for 27% of patients.


CONCLUSIONS
The surgical correction of trapeziometacarpal osteoarthritis of the thumb is frequently performed according to an ambulatory setting. The fact that 50% of patients reported severe pain during the early postoperative period emphasize the inadequacy of our postoperative pain management for this surgical procedure.
Département d'anesthésie-réanimation chirurgicale, hôpital Central, 29, avenue Lattre-de-Tassigny, 54035 Nancy, France.
F
F
Vial
H
H
Bouaziz
G
G
Mekler
C
C
Cornet
M
M
Merle
M C
MC
Laxenaire
D000082:Acetaminophen / Q000008:administration & dosage*; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000700:Analgesics / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D011431:Dextropropoxyphene / Q000008:administration & dosage*; D004359:Drug Therapy, Combination; D005260:Female; D005384:Finger Joint; D006801:Humans; D007660:Ketoprofen / Q000627:therapeutic use*; D008875:Middle Aged; D010003:Osteoarthritis / Q000601:surgery*; D010147:Pain Measurement; D010149:Postoperative Pain / Q000453:epidemiology / Q000517:prevention & control*; D011446:Prospective Studies; D013933:Thumb; D013997:Time Factors
D000700:Analgesics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000082:Acetaminophen; D007660:Ketoprofen; D011431:Dextropropoxyphene