Profiles of pain after day surgery: patients' experiences of three different operation types.
OBJECTIVE
The aim of this paper is to examine the pain profile of three types of day surgery operation and undertake a comparative analysis of the intensity and duration of pain over a consecutive 4-day period.


BACKGROUND
Although studies on pain after day surgery have figured prominently, evidence is limited as to what intensity and duration of pain should be regarded as unacceptable, and how it varies for different operation types.


METHODS
A prospective postal survey (n = 785) was undertaken during a 12-month period in 1998/1999 involving three day surgery units in three different areas in England and Wales and based on three commonly performed operation types: hernia repair, varicose vein surgery and laparoscopic sterilization. A visual analogue scale was used to measure the intensity of pain experienced over a 4-day consecutive time period. Analysis of variance was used to explore statistically significant differences between levels of pain for the operation types.


RESULTS
On the day of surgery and even on the third postoperative day, high levels of severe pain (>50 mm on a Visual Analogue Scale) were experienced. Pain levels differed across different operation types. On the day of surgery, more patients undergoing laparoscopic sterilization experienced severe pain. By the third postoperative day, more of those who had been operated on for hernia repair, followed by varicose vein surgery and laparoscopic sterilization, continued to experience severe pain.


CONCLUSIONS
A large number of patients experienced severe levels of pain after day surgery. This could have resulted from a lack of knowledge about the assessment and management of pain, in which nurses play an important role. This study has highlighted that different pain trajectories are associated with different operation types, and this has important implications for the preoperative and postoperative preparation of day surgery patients as well as the role of nurses in the overall success of the day surgery process.
Coll
Anne Marie
AM
Senior Lecturer, Research Unit, School of Care Sciences, University of Glamorgan, Pontypridd, UK. amcoll@glam.ac.uk
Ameen
Jamal
J
D000293:Adolescent; D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects* / Q000451:nursing; D001294:Attitude to Health; D004739:England; D004812:Epidemiologic Methods; D005260:Female; D059685:Herniorrhaphy; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D010149:Postoperative Pain / Q000209:etiology* / Q000451:nursing; D013246:Sterilization, Tubal / Q000009:adverse effects; D014648:Varicose Veins / Q000601:surgery; D014852:Wales