Abstract

RODRIGUEZ DE LA TORRE, R. et al. Home invasive analgesia in the management of postoperative pain alter outpatient major surgery using intravenous elastomeric pumps. Rev. Soc. Esp. Dolor [online]. 2011, vol.18, n.3, pp.161-170. ISSN 1134-8046.

Introduction: moderate to severe postoperative pain is still a problem in outpatient surgery, since it causes patient flow problems and delays the discharge of patients, being one of the major causes of re-hospitalization and hence a relevant quality indicator of these Units. The use of home invasive analgesic techniques, in all their regimes, can be effective for the management of postoperative pain in these surgical procedures and allow them to be included in outpatient surgery programs. Objectives: the aim of our study was to determine the feasibility and safety of the use of elastomeric continuous perfusion pumps for the administration of home continuous endovenous analgesia, as well as to assess analgesic effectiveness and degree of satisfaction of patients undergoing outpatient surgerys. Material and methods: we conducted a simple retrospective study in 463 patients. After the surgical procedure was performed under multimodal analgesia, two differents elastomeric endovenous pumps (dexketoprofeno pump or metamizol pump) were used. Pain intensity by means of a visual analog scale and a plain oral scale, the need for supplemental analgesics. At home (24 hours after the surgical operation), the Home Care Unit checked side effects, sleep disorders, pain intensity, need of rescue analgesia and degree of satisfaction. Results: 69% of the patients report absence or slight pain 24 h after the surgical operation, just 16 out of 463 patients of the study had severe pain. The 27% of patients required rescue therapy and the 9% of the patients reported side effects attributable to analgesics (4% of the patient vomited, 2% had dizziness, 2,5% drowsiness and 0,5% insomnia). No patient required readmission after discharge. A 83% of patients reported a high degree of satisfaction, a 16% of patients moderate satisfaction and a 0,2% poor satisfaction with the infusion system and the procedure. Conclusion: our study has shown the feasibility and safety of the use of endovenous elastomeric infusion pumps as a method of postoperative analgesia that allow to manage cases of moderate or severe pain after outpatient surgical procedures. However, further studies are required to compare this technique with conventional analgesic techniques, as well as with different infusion regimes.

Keywords : Home invasive analgesia; Elastomeric infusion pumps; Postoperative pain management; Ambulatory surgery.

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