Daycase laparoscopic cholecystectomy: a prospective study of post-discharge pain, analgesic and antiemetic requirements

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Abstract

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.

Aims

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%.

Conclusion

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.

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