Pain After Outpatient Surgical Procedures

Area of Science:

• Surgical Quality Improvement
• Pain Management Research
• Ambulatory Surgery Outcomes

Background:

• Over 8.1 million outpatient surgical procedures occurred in Germany in 2021.
• Limited data exists on postoperative pain management quality in ambulatory settings.

Purpose of the Study:

• To determine the prevalence of significant incisional pain up to postoperative day 3.
• To identify prognostic variables for pain and associated outcomes in outpatient surgery.

Main Methods:

• Analysis of data from 330,008 patients (July 2001-December 2021) via the AQS1 project.
• Primary endpoint: prevalence of relevant incisional pain (≥ 4/10 NRS) by postoperative day 3.
• Secondary endpoints: prognostic factors and pain associations using patient questionnaires and mixed regression models.

Main Results:

• Overall prevalence of relevant incisional pain was 22.5%, ranging from 3.2% to 51.2% across procedure types.
• Highest pain prevalence observed after hemorrhoid surgery (51.2%) and laparoscopic lysis of adhesions (45.4%).
• Key pain predictors included younger age, early postoperative pain, insufficient analgesics, and surgical wound infections. Pain correlated with lower satisfaction and prolonged inability to work.

Conclusions:

• Data suggest significant variability in postoperative pain after ambulatory surgery.
• Findings provide a basis for optimizing pain therapy and designing future studies, though data representativeness requires further testing.