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The Prevalence of Postoperative Pain in a Cross-sectional Group of Patients After Day-case Surgery in a University Hospital

Gramke, Hans-Fritz MD*; de Rijke, Janneke M. PhD; van Kleef, Maarten MD, PhD*; Raps, Freya MD*; Kessels, Alfons G. H. MD, MSc; Peters, Madelon L. PhD§; Sommer, Michael MD*; Marcus, Marco A. E. MD, PhD*

doi: 10.1097/AJP.0b013e318074c970
Original Articles

Objectives Although a great variety of surgical procedures are performed on an ambulatory basis, little is known about postoperative pain experience at home after ambulatory surgery. This study was performed to assess the prevalence and course of postoperative pain in the early postoperative period after ambulatory surgery.

Methods Over a period of 4 months, 648 patients who underwent day-case surgery were included in our study. Data were collected with interviews and questionnaires. Pain intensity was measured using a visual analog scale (VAS) during 4 days after surgery. Side effects of anesthesia and analgesia techniques were also recorded.

Results On the day of the operation, 26% of the patients had moderate to severe pain (defined as mean VAS >40 mm). Mean VAS-scores were greater than 40 mm in 21% on postoperative day (POD) 1, in 13% on POD 2, in 10% on POD 3, and in 9% on POD 4. Operations of nose and pharynx, abdominal operations, plastic surgery of the breasts, and orthopedic operations were the most painful procedures during the first 48 hours.

Discussion This study showed that an important number of patients still experience moderate to severe pain in the postoperative period after day-case surgery even after a 4-day period. Furthermore, the type of operation should be considered when planning postoperative analgesia for ambulatory surgery.

*Department of Anesthesiology and Pain Therapy

Pain Management and Research Centre

Department of Clinical Epidemiology and Medical Technology Assessment, University Hospital Maastricht

§Department of Medical, Clinical and Experimental Psychology, Maastricht University, Maastricht, The Netherlands

Reprints: Hans-Fritz Gramke, MD, Department of Anesthesiology and Pain Therapy, University Hospital Maastricht, PO Box 5800, 6202 AZ Maastricht, The Netherlands (e-mail:

Received for publication May 2, 2006; accepted April 17, 2007

© 2007 Lippincott Williams & Wilkins, Inc.