Does take-home analgesia improve postoperative pain after elective day case surgery? A comparison of hospital vs parent-supplied analgesia.

摘要

More children are undergoing same-day surgery. While advances have been made in pediatric pain management, there have been few studies addressing pain management in the home (Br J Anaesth, 82, 1999 and 319). We wished to investigate whether issuing parents with take-home analgesia would improve postoperative pain scores and/or parental satisfaction following hospital discharge.Two hundred children, and their parents, attending for day case surgery at our institution were randomized into two groups. One group received advice regarding the management of postoperative pain and were given a pack containing discharge medications: group 'dispensed'. The other group received the same advice, but did not receive any medication: group 'advised'. Telephone interviews were conducted to assess pain scores, PONV, functional activity, analgesia requirements, and satisfaction rates.Data were available for 181 patients (median age, 4?years; range, 0-12?years): 89 children in group 'dispensed' and 92 children in group 'advised'. Postoperative instructions were followed by 86% in group 'advised' and 89% in group 'dispensed' (P?=?0.68). Although all parents received analgesia advice, only 85/181 (48%) recalled the information. Rates for no/mild pain and moderate/severe pain were similar between the two groups: 59% (group 'advised') vs 62% (group 'dispensed') and 41% (group 'advised') vs 38% (group 'dispensed') (P?=?0.78).Our study did not show any differences in the incidence of pain/parental satisfaction between the two groups. Analgesia advice given to parents was poorly retained, suggesting that other methods for disseminating information should be considered.