Introduction

Minor surgery implies an operation on the superficial structures of the body, and in general those procedures that do not involve a serious risk for the Patients. A “Day care surgery” implies that the operation or surgical procedure not requiring an overnight stay in hospital. It is generally addressed to healthy people (ASA 1, ASA 2) that usually go home a few hours after the procedure. Does minor surgery imply fewer anaesthic challenges and less post operative pain?

Materials and Methods

In 2018-2020 our centre was involved in the PAIN OUT project [1], an Observational Prospectic Cohort study committed to the improvement in postoperative pain (QUPIS). Up to that point (before 2018) Day Care/Service based Surgery/Anesthesia had not been included in the project’s registry, despite this care setting is more and more common and diffused.

Results

• 69 Patients (F 43%, M 57%)
• ASA 1-2
• Mean age for the different surgeries was: Breast Surgery (44.3, St.Dev. 13.4), Orthopedics (36.8, St.Dev. 14.2), Urology (39, St.Dev 15.1), Gynecology (39.6, St.Dev. 8.1).
• TCI propofol sedation with fentanyl (46%) under BIS neuromonitoring
• ENS/ultrasound guided peripheral nerve block (32%)
• Patients suffering from chronic pain and anxiety amounted to 26%.
• Worst pain (NRS) the day after surgery: Breast surgery (2.5, St.Dev. 1.56), Orthopedics (3.4, St.Dev. 0,8), Urology/Ginecology (4.8, St.Dev. 1.64)
• Patients who wished more/better pain killers at home amounted to 8% (Breast surgery) and 20% (Orthopedic surgery)
• The most common painkiller prescribed at home was paracetamol 1g x3/die

Discussion and conclusion

PAIN OUT is very likely to help physicians working in the setting  illustrated above, allowing them to get a broader picture of the whole perioperative period, especially in the postoperative pain control follow up.

References

1. PAIN-OUTcome project. ClinicalTrials.gov Identifier: NCT02083835 - https://clinicaltrials.gov/ct2/show/NCT02083835