Daycase laparoscopic cholecystectomy: a prospective study of post-discharge pain, analgesic and antiemetic requirements.
BACKGROUND
Laparoscopic cholecystectomy has been performed as a day-case procedure for over a decade. This procedure can be associated with a high incidence of pain and post-operative nausea and vomiting (PONV). There is a paucity of information regarding the post-discharge care of these patients.


OBJECTIVE
To determine the effectiveness and adequacy of take-home analgesic packs given to patients undergoing ambulatory surgery.


METHODS
A prospective study of 40 patients undergoing laparoscopic cholecystectomy to evaluate post-operative pain, analgesia requirements and PONV following discharge. Data regarding unplanned admissions, patient satisfaction and GP attendance rates were also recorded.


RESULTS
At 24 h, 65% of patients reported moderate pain, 23% severe pain and 25% of patients reported PONV. The rate of GP attendance for further analgesia or antiemetics was 12.5%. Unexpected admission rate was 10%.


CONCLUSIONS
The incidence of PONV post-discharge suggests that adding an antiemetic to our take-home analgesic packs may improve patient comfort. The 2-day supply of diclofenac and co-codamol could also be extended as 65% of patients had moderate to severe pain. The information gathered shows the importance of post-discharge follow-up of ambulatory surgery patients.
Kavanagh
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Department of Anaesthesia, Intensive Care and Pain Medicine, Adelaide and Meath Hospital, Incorporating the National Children's Hospital, Belgard Road, Tallaght, Dublin 22, Ireland. trevorkavanaghster@gmail.com
Hu
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Minogue
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D000082:Acetaminophen / Q000627:therapeutic use; D000359:Aftercare / Q000592:standards; D000556:Ambulatory Surgical Procedures / Q000009:adverse effects* / Q000592:standards; D000700:Analgesics / Q000627:therapeutic use*; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects*; D003061:Codeine / Q000627:therapeutic use; D004008:Diclofenac / Q000627:therapeutic use; D004338:Drug Combinations; D005260:Female; D006801:Humans; D008297:Male; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy* / Q000209:etiology; D017060:Patient Satisfaction; D020250:Postoperative Nausea and Vomiting / Q000188:drug therapy* / Q000209:etiology; D011446:Prospective Studies
D000700:Analgesics; D004338:Drug Combinations; C526278:acetaminophen, codeine drug combination; D004008:Diclofenac; D000082:Acetaminophen; D003061:Codeine