title: [Evaluation of the impact of prescription analgesic during the anaesthesia consultation on the incidence of postoperative pain at home in ambulatory orthopaedic surgery].
abstract: BACKGROUND
  Postoperative pain at home in ambulatory surgery is a major problem. To improve its management, the French society of anaesthesia emphasizes the importance of writing prescriptions for analgesic during the preanaesthetic consultation. The objective of this study was to assess the impact of this prescription on the incidence of postoperative pain at home in ambulatory orthopaedic surgery.
  
  
  METHODS
  We conducted a prospective evaluation in the ambulatory surgery unit of Rouen University Hospital. We were able to identify two periods of 1 year with implementation of a systematic prescription of analgesics during the postoperative period (P1) or during the preanaesthetic consultation (P2). The evaluation of this measurement was made by a telephone survey conducted the day after surgery. The main parameter was the incidence of postoperative pain at home defined by the occurrence of a pain greater to 3/10 on a numerical scale (FR). Secondary parameters were demographic and anaesthetic data, the incidence of moderate pain (FR ≤ 3), treatment adherence and patient satisfaction.
  
  
  RESULTS
  We included 638 patients and 531 were analysed: 28% of patients had an EN greater than 3 the day following surgery. There is no difference between the two periods (30% for P1 versus 27% for P2). The analysis of subgroups showed that in the general anaesthesia group, 30% of patients had an EN greater than 3 for P1 versus 18% for P2 (P<0.01). Furthermore, 55% of patients expressed moderate pain (FR ≤ 3) for P1 versus 22% for P2 (P<0.01). Moreover, 89% of patients reported having an adequate analgesic treatment. The overall observance was 64%, 53% for P1 versus 75% for P2 (P<0.01).
  
  
  CONCLUSIONS
  The systematic prescription of analgesics during the preanaesthetic consultation does not decrease the intensity of moderate to severe pain. On the other hand, this procedure seems to be positive for the people who underwent a general anaesthesia.
authors: Département d'anesthésie-réanimation, CHU de Rouen, 1, rue de Germont, 76031 Rouen, France.
authors: M
authors: M
authors: Lemarie
authors: V
authors: V
authors: Compère
authors: V
authors: V
authors: Fourdrinier
authors: S
authors: S
authors: Lignot
authors: L
authors: L
authors: Legrand
authors: C
authors: C
authors: Marguerite
authors: C
authors: C
authors: Devellenne
authors: G
authors: G
authors: Wood
authors: F
authors: F
authors: Dujardin
authors: B
authors: B
authors: Dureuil
mesh_terms: D000328:Adult; D000556:Ambulatory Surgical Procedures; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D019637:Orthopedic Procedures; D010149:Postoperative Pain / Q000453:epidemiology* / Q000517:prevention & control*; D011229:Preanesthetic Medication; D011446:Prospective Studies
chemical_list: D000700:Analgesics