Early Administration of Oral Analgesia Following General Anesthesia in Ambulatory Surgery Patients

Paper

Friday, 21 July 2006

This presentation is part of : Using Evidence to Determine Health Strategies

Kelly E. Lancaster, RN, BSN, Dept of Nursing, Ambulatory Surgery Center, Brighton Campus, Maine Medical Center, Portland, ME, USA

Learning Objective #1: Identify effects of early oral analgesia and oral fluid administration following general anesthesia on the occurrence of postoperative nausea and vomiting in ambulatory surgery patients.
Learning Objective #2: Identify the effects of early oral analgesia administration following general anesthesia on postoperative pain and length of stay in ambulatory surgery patients.

Significance
     Researchers have extensively studied pain scales, multimodal and pre-emptive analgesia but have not studied the timing of oral postoperative analgesic administration. Current clinical practice is based on trial and error and myths and misconceptions rather than evidence-based research. In the absence of sufficient research, the practice is based on anecdotal information and expert opinion, resulting in wide variations.
     The purpose of this study is to determine if early administration of oral analgesia and oral fluids following general anesthesia in ambulatory surgery patients affects the occurrence of postoperative nausea and vomiting, level of pain and length of stay compared to patients that received later administration of oral analgesia and oral fluids.
Methods
      Anecdotally in our ambulatory surgery setting, early oral analgesia administration has shown some success in improving outcomes related to pain control and length of stay without a noticeable effect on the occurrence of nausea and vomiting. Unable to find existing external evidence regarding the practice of oral analgesia and /or oral fluid initiation, a retrospective data collection from 1,150 charts of adult general surgery patients receiving general anesthesia for ambulatory surgical procedures was performed.
Outcomes Evaluation
     Data synthesis is in process and final results will be presented at the conference. Outcome results will compare level of pain, occurrence of postoperative nausea and vomiting and length of stay in early analgesia / oral fluid administration compared to late oral analgesia /oral fluid administration.
Implications for Practice
     The early administration of oral analgesia and oral fluids in the postoperative period may affect pain, nausea and vomiting, recovery, and discharge from the day surgery unit. Practices that affect pain, PONV and length of stay in PACU and ASU can have a patient benefit as well as cost benefit effect on the units as well.

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