Postoperative Pain Level Following Surgery of the Hand and Wrist in the Ambulatory Setting

Surgical procedures of the hand are increasingly performed in an ambulatory setting. Postoperative analgesia is based empirically on the painfulness of individual surgical procedures without these having been examined systematically.

The painfulness (visual analogue scale) of 722 surgical procedures of the hand and wrist (1 July 2021 to 30 June 2023) was assessed until day 5. Analgesia was conducted empirically in accordance with WHO principles. The primary endpoint was the pain sensation on the first postoperative day in bone and joint procedures compared with soft tissue or endoscopic procedures as well as hardware removals. Secondary endpoints were pain sensation in correlation with gender, age, duration of the procedure and preoperative analgesia.

Bone and joint procedures were associated with significantly (p<0.001) more pain (5.42±2.8) compared with other procedures (3.47±2.6). Female (p=0.001) and younger patients (R>0.2) as well as longer procedure duration (R>0.2) showed a weak association with higher postoperative pain, whereas preoperative consumption of opioids was moderately associated with higher opioid intake (R=0.34). Overall, pain decreased continuously from the evening of the procedure (4.4±2.8) until day 5 (3.7±2.7; 2.8±2.4; 2.1±2.1; 1.6±1.9; 1.3±1.7) CONCLUSION: This data provides a scientific basis for pain medication supply following surgical procedures of the hand and wrist in an ambulatory setting. A broad range of pain perception must be considered, even in seemingly minor surgical procedures.