Low admittance rate after ambulatory laparoscopic surgery

Reducing intra-abdominal pressure from 12 mmHg to 6-8 mmHg during laparoscopy may reduce pain after minor laparoscopic procedures. We hypothesised that post-operative pain following ambulatory laparoscopic surgery was a limiting factor for day surgery. The primary aim of the study was to analyse risk factors for hospital admittance following laparoscopic ambulatory surgery.

In this explorative prospective uncontrolled study, patients were included consecutively from 1 June 2013 to 31 March 2015 in an ambulatory setting using a standardised anaesthetic and post-operative multimodal analgesic regimen. Patients underwent the following three surgical procedures: laparoscoscopic cholecystectomy and laparoscopic inguinal and umbilical hernia repair. In the post-anaesthesia care unit, pain was repeatedly recorded using a visual analogue scale. The need for intravenously administered on-demand sufentanil was registered. The main reason for admittance to hospital was registered in a structured questionnaire.

A total of 1,212 consecutive patients were included. Post-operative pain was the main reason for admittance in 14 patients, and 97% of all patients were discharged after a median of 5 h post-operatively (range: 0.4-5.0 h).

In patients undergoing ambulatory laparoscopic surgery using a perioperative multimodal analgesic regimen, pain was the limiting factor for discharge in 1% of patients operated in an ambulatory set-up.

none.

Danish Data Protection Agency: 2012-58-0004, Danish Health Authority: 3-3013-1435/1, Clinicaltrial.gov: NCT02782832.