Identifying Predictors of Early Postoperative Pain and Patient Satisfaction Following Day Surgery: Insights From an Observational Study

Abstract

Background Effective management of postoperative pain in the day surgery unit (DSU) is crucial to ensure patient safety and improve satisfaction. The management of postoperative pain in the DSU is challenging due to short hospital stays, variability in the procedures, and physician practices. This study aims to identify factors linked to severe postoperative pain and patient satisfaction levels in the DSU to improve pain management and patient outcomes. Methodology This multicenter prospective observational study included 395 patients undergoing different same-day surgical procedures under general anesthesia (GA), regional anesthesia (RA), or combined anesthesia (GA+RA). Data included baseline patient characteristics, anesthetic technique, surgical procedure, interventions like local anesthetic infiltrations, patient education, and pain outcomes. Postoperative pain assessment was done using the Numerical Rating Scale (NRS). Statistical analysis was done to identify the pain outcomes, correlations, and predictors of severe pain and satisfaction. Severe pain is recognized as a pain score (>7/10) by NRS. Results The study included 395 patients undergoing different surgical procedures, including Orthopedic (Ortho), obstetrics/gynecology (Ob/Gyn), general surgery (GS), bariatric, urology, and plastic surgeries. Key factors linked to severe postoperative pain included female gender, presence of preoperative pain, and lack of local anesthetic (LA) infiltration. Women experienced more severe pain than men did (55.4% vs. 44.6%). At the same time, men experienced relatively higher satisfaction than women did (6.1 vs. 5.68). LA infiltration reduced worst pain scores (from 6.39 to 5.68) and improved satisfaction (from 5.21 to 6.11). Preoperative education on postoperative pain and pain relief methods reduced worst pain scores (from 6.14 to 5.66) and improved satisfaction (from 5.53 to 6.13). Combined GA+RA provided better pain outcomes than GA or RA alone. Regarding the surgical procedures, Ortho and Ob/Gyn surgeries had the highest incidence of severe pain (40.7% and 40.5%), while urology and plastic surgery patients reported higher satisfaction scores. Conclusions Severe postoperative pain in DSU is influenced by gender, preoperative pain, and type of anesthesia. Some interventions, such as LA infiltration, preoperative education, and combined GA+RA, significantly improved pain outcomes and satisfaction. Strategies like procedure-specific postoperative pain management are recommended to enhance pain outcomes and patient satisfaction.