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Pain experienced by laparoscopic donor nephrectomy patients in an academic medical setting
Michele M Steinhauser1, Patricia B Dawson, Rebecca M Barshick
1The Johns Hopkins Hospital, Baltimore, Md, USA.
Context:
Since 1996, 414 laparoscopic live donor nephrectomy procedures have been completed at our institution. Although this procedure has gained acceptance within the past 5 years, little is known about its nursing implications.
Objective:
The purpose of this performance improvement project was to identify pain management practices, satisfaction levels, and clinical outcomes among patients undergoing laparoscopic live donor nephrectomy.
Patients:
Data were collected for a convenience sample of 70 patients for 18 months.
Intervention:
Several pain management methods were used, including patient-controlled analgesia and intramuscular and oral medications.
Results:
Pain ratings ranged from 3.2 to 3.8 for the first 36 hours postoperatively. The mean pain level did not differ significantly between pain regimes. At discharge, patients perceived a mean overall pain level of 5.0 but anticipated a pain level of 6.1. A significant negative correlation between satisfaction and pain rating also was noted.
Conclusions:
Opportunities exist to standardize current regimens of pain medications and address pain level and treatment 24 hours postoperatively.