title: Low Pain Score After Total Laparoscopic Hysterectomy and Same-Day Discharge Within Less Than 5 Hours: Results of a Prospective Observational Study.
abstract: OBJECTIVE
  To present a descriptive study on same-day discharge after total laparoscopic hysterectomy (TLH), documenting the effectiveness of our preoperative and postoperative protocol, and surgical technique for minimizing postoperative pain scores in case of uterine volume equivalent to <14 weeks of gestation.
  
  
  METHODS
  Prospective observational study (Canadian Task Force classification II-2).
  
  
  METHODS
  University hospital.
  
  
  METHODS
  One hundred and five patients undergoing TLH, with same-day discharge.
  
  
  METHODS
  Anesthesia and surgery were performed using the same protocol in all patients.
  
  
  RESULTS
  Primary endpoints evaluated pain scores using a visual analog scale (VAS). Secondary endpoints included duration of surgery, operating room occupancy, time to discharge, overnight hospitalization, complication rate, readmission rate and patient satisfaction. All (100%) patients were able to return home within 4.9 ± 1.4 hours of surgery. At 1 hour after surgery, the mean VAS score was <4 (3.5 ± 2.6); the mean score dropped to <2 (1.9 ± 1.2) by 4 hours after surgery and remained so throughout day 1 (1.8 ± 1.4). Thus, VAS scores were significantly lower at 4 hours and day 1 postsurgery than at 1 hour postsurgery.
  
  
  CONCLUSIONS
  Our results clearly confirm that outpatient TLH is a feasible procedure, allowing same-day discharge and generating low levels of pain. Patients can leave the hospital in less than 5 hours after surgery. Standardized techniques, as well as coordination with the anesthesiologist, adequate postoperative nursing care, and preoperative patient counseling, are required.
authors.affiliation: Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium. Electronic address: pr.olivier.donnez@gmail.com.
authors.forename: Olivier
authors.initials: O
authors.lastname: Donnez
authors.affiliation: Société de Recherche pour l'Infertilité, Brussels, Belgium.
authors.forename: Jacques
authors.initials: J
authors.lastname: Donnez
authors.affiliation: Pôle de Recherche en Gynécologie, Institut de Recherche Expérimentale et Clinique, Université Catholique de Louvain, Brussels, Belgium; Cliniques Universitaires Saint Luc, 1200 Brussels, Belgium.
authors.forename: Marie-Madeleine
authors.initials: MM
authors.lastname: Dolmans
authors.affiliation: Department of Gynecology, CHU Mont-Godinne, Yvoir, Belgium.
authors.forename: Alice
authors.initials: A
authors.lastname: Dethy
authors.affiliation: Department of Gynecology, CHU Mont-Godinne, Yvoir, Belgium.
authors.forename: Marie
authors.initials: M
authors.lastname: Baeyens
authors.affiliation: Department of Anesthesiology, CHU Mont-Godinne, Yvoir, Belgium.
authors.forename: John
authors.initials: J
authors.lastname: Mitchell
mesh_terms: D000758:Anesthesia / Q000379:methods*; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000379:methods*; D010535:Laparoscopy / Q000379:methods*; D008875:Middle Aged; D010147:Pain Measurement; D010149:Postoperative Pain / Q000188:drug therapy*; D010351:Patient Discharge / Q000706:statistics & numerical data*; D017060:Patient Satisfaction / Q000706:statistics & numerical data*; D011446:Prospective Studies; D016896:Treatment Outcome
keywords: Laparoscopic hysterectomy; Pain score; Same-day discharge