Pain experienced by laparoscopic donor nephrectomy patients in an academic medical setting.
BACKGROUND
Since 1996, 414 laparoscopic live donor nephrectomy procedures have been completed at our institution. Although this procedure has gained acceptance within the past 5 years, little is known about its nursing implications.


OBJECTIVE
The purpose of this performance improvement project was to identify pain management practices, satisfaction levels, and clinical outcomes among patients undergoing laparoscopic live donor nephrectomy.


METHODS
Data were collected for a convenience sample of 70 patients for 18 months.


METHODS
Several pain management methods were used, including patient-controlled analgesia and intramuscular and oral medications.


RESULTS
Pain ratings ranged from 3.2 to 3.8 for the first 36 hours postoperatively. The mean pain level did not differ significantly between pain regimes. At discharge, patients perceived a mean overall pain level of 5.0 but anticipated a pain level of 6.1. A significant negative correlation between satisfaction and pain rating also was noted.


CONCLUSIONS
Opportunities exist to standardize current regimens of pain medications and address pain level and treatment 24 hours postoperatively.
Steinhauser
Michele M
MM
The Johns Hopkins Hospital, Baltimore, Md, USA.
Dawson
Patricia B
PB
Barshick
Rebecca M
RM
Janecek
Jennifer L
JL
D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D015142:Baltimore; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects* / Q000523:psychology; D007902:Length of Stay / Q000706:statistics & numerical data; D019520:Living Donors / Q000523:psychology; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009392:Nephrectomy / Q000009:adverse effects* / Q000523:psychology; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control / Q000523:psychology; D010359:Patient Readmission / Q000706:statistics & numerical data; D017060:Patient Satisfaction; D011795:Surveys and Questionnaires; D013997:Time Factors; D017749:Total Quality Management