An investigation of pain experience and management following gynecological day surgery: differences between open and closed surgery.

Abstract

This study aimed to investigate the pain and activity levels of patients for a 5-day period following gynecological day surgery. Patients recorded their degree of pain and activity on visual analogue scales in a diary; completed diaries were returned by 54.9% of the patients approached (106 of 193). The median age of the women was 28.5 years (range, 15-55 years). Each procedure was classified as either open or closed surgery, depending upon whether an incision was necessary. Most (63.2%) of the patients required analgesics on the first morning after their surgery. Open surgery patients experienced significantly more pain for at least 3 postoperative days and were less active until the fifth day (P < 0.05 by Mann-Whitney tests). Drowsiness (47.2%), nausea (30.2%), and headache (30.2%) were the most common adverse effects experienced in the first postoperative morning. The incidence of adverse effects declined over the five days, but a minority of patients still suffered with headache (14.2%), drowsiness (9.4%), sore throat (7.5%), and nausea (5.3%) on the fifth day following surgery. The percentage of patients who experienced constipation peaked at 19.8% on the second day, most likely reflecting the consumption of codeine-containing analgesics on the first and second postoperative days. While day surgery has an important role in many forms of gynecological surgery, the potential discomfort and recovery time following day surgery should not be underestimated.