Outpatient multimodal intravenous analgesia in patients undergoing day-case surgery: description of a three year experience.
The use of elastomeric devices for ambulatory intravenous pain treatment in Major Ambulatory Surgery (MAS) has been described to improve postoperative pain management. The objective of the study was to describe the first 3 years experience of the use of elastomeric devices for ambulatory intravenous pain treatment in MAS implemented at our site since 2010.



Data were retrieved from the medical records for all patients who, between January 2010 and March 2014, underwent surgical procedures at the ambulatory surgical centre at our hospital and were prescribed a home-based continuous intravenous analgesia.



Data were retrieved from the medical records of 1128 patients. The most frequent surgical interventions included orthopedic and proctology surgeries. 80 % of patients were discharged home without pain; during the first 48 h after discharge roughly 40 % of subjects were completely free of pain, 50 % reported mild pain (VAS 1 to 3) and 9 % reported higher pain scores (4 and above). Peripheral nerve block was associated to better pain control in the immediate postoperative period. Vomiting in the first 24 h was 4.6 % before introducing haloperidol into the drug schemes, and 2.6 % thereafter. Complications related with the intravenous route required treatment withdrawal in 1.1 % cases. Only 3.5 % of patients returned to the hospital in the first 72 h, mainly for non-pain related reasons. Overall, 99.5 % of patients were satisfied with the treatment received at home.



Our initial experience suggest that outpatient multimodal intravenous analgesia in patients undergoing day-case surgery is a feasible alternative in our setting, that allows an effective management of postoperative pain with a small rate of adverse events and complications requiring readmission.
Anesthesiology Department, Hospital de Sabadell, Institut Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
Magdalena
M
Serra
Clinical Pharmacology Unit, Hospital de Sabadell, Institut Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.|Departamento de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Edifici Taulí planta -1 Hospital de Sabadell C/ Parc taulí n° 1, Sabadell, Barcelona, 08208, Spain.
Roser
R
Vives
Anesthesiology Department, Hospital de Sabadell, Institut Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
Montserrat
M
Cañellas
Anesthesiology Department, Hospital de Sabadell, Institut Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
Josep
J
Planell
Statistics Unit, Institut d'Investigació e Innovació Parc Taulí, Sabadell, Barcelona, Spain.
Joan Carles
JC
Oliva
Anesthesiology Department, Hospital de Sabadell, Institut Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain.
Carmen
C
Colilles
Clinical Pharmacology Unit, Hospital de Sabadell, Institut Universitari Parc Taulí - Universitat Autònoma de Barcelona, Sabadell, Barcelona, Spain. caridad.pontes@uab.cat.|Departamento de Farmacologia, de Terapèutica i de Toxicologia, Universitat Autònoma de Barcelona, Edifici Taulí planta -1 Hospital de Sabadell C/ Parc taulí n° 1, Sabadell, Barcelona, 08208, Spain. caridad.pontes@uab.cat.
Caridad
0000-0002-3274-6048
C
Pontes
D061605:Administration, Intravenous; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000556:Ambulatory Surgical Procedures / Q000379:methods*; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects / Q000627:therapeutic use*; D020724:Elastomers / Q000008:administration & dosage; D005260:Female; D006801:Humans; D007260:Infusion Pumps; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D059408:Pain Management / Q000379:methods; D010149:Postoperative Pain / Q000188:drug therapy*; D017060:Patient Satisfaction; D012189:Retrospective Studies; D055815:Young Adult
D000700:Analgesics; D020724:Elastomers
Ambulatory Surgery; Domiciliary care; Elastomer; Intravenous Analgesia