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Barat E, Chenailler C, Gillibert A, Pouplin S, Varin R, Compere V. Impact of Clinical Pharmacist Consultations on Postoperative Pain in Ambulatory Surgery. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:3967. [PMID: 36900980 PMCID: PMC10001952 DOI: 10.3390/ijerph20053967] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 06/18/2023]
Abstract
Post-operative pain is a common symptom of ambulatory surgery. The objective of this study was to evaluate a pain management protocol integrating a pharmacist consultation. We conducted a quasi-experimental, single center, before-after study. The control group was recruited between 1 March and 31 May 2018 and the intervention group between 1 March and 31 May 2019. Outpatients in the intervention group received a pharmacist consultation, in addition to the usual anesthesiologist and nurse consultations. Pharmacist consultations were conducted in two steps: the first step consisted of general open-ended questions and the second step of a specific and individualized pharmaceutical interview. A total of 125 outpatients were included in each group. There were 17% (95% CI 5 to 27%, p = 0.022) fewer patients with moderate to severe pain in the pharmaceutical intervention group compared with the control group, which corresponded to a decrease in the mean pain level of 0.9/10 (95% CI -1.5/10; -0.3/10; p = 0.002). The multivariate analysis did not reveal any confounding factors, showing that only the pharmaceutical intervention could explain this result. This study demonstrates a positive impact of pharmacist consultations on postoperative pain in ambulatory surgery.
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Affiliation(s)
- Eric Barat
- Department of Pharmacy, CHU Rouen, CEDEX, 76031 Rouen, France
- Department of Pharmacy, Normandie University, UNICAEN, Inserm U1086, 14000 Caen, France
| | | | - André Gillibert
- Department of Biostatistics, CHU Rouen, CEDEX, 76031 Rouen, France
| | - Sophie Pouplin
- Department of Rheumatology, CHU Rouen, CEDEX, 76031 Rouen, France
| | - Remi Varin
- Department of Pharmacy, UNIROUEN, Inserm U1234, CHU Rouen, Normandie University, Rouen, CEDEX, 76031 Rouen, France
| | - Vincent Compere
- Department of Anesthesiology and Critical Care, CHU Rouen, CEDEX, 76031 Rouen, France
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Carricaburu A, Mouton J, Nseir I, Beccari R, Gandolfi S, Auquit-Auckbur I. Ambulatory hand emergency: 2 years-experience in an public university hospital center. Acta Orthop Belg 2021. [DOI: 10.52628/87.2.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Hand emergencies represent the most frequent traumatic injuries and outpatient surgery is still improving. It will achieve 70% of total surgeries by 2022.
Our hand trauma center has been able to set up an emergency day surgery department in a university hospital center.
With this article, we would like to report the ambula- tory care management and practice for hand emer- gencies in our university hospital center over 2 years. 892 patients suffering from hand traumas and managed in our day surgery department, were retro-spectively reviewed between January 2016 and December 2017. Patients’ demographic data, anesthe- tic data, trauma’s circumstances, medical care and surgical outcomes have been disclosed. A descriptive analysis and a statistical assessment was realized.
Cut injury was the most recorded case, followed by impactions. Tendon injuries were the most frequent (32%), followed by fractures (26%), and exposed joints (18%). 13% of injuries were nil findings. Average patient care delay was 1.16 days. Mean of hospitalization was 7.5 hours. 16/892 patients needing intravenous antibiotics required hospitalization. 41 complications including 27 secondary surgeries were reported.
Hospital facilities are forced to reassess their entire procedures to achieve efficiency and improvement for healthcare. Progress in outpatient surgery permits emergency management in hand surgery, improving patient cares both medically and economically.
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Selim J, Djerada Z, Chaventre C, Clavier T, Dureuil B, Besnier E, Compere V. Preoperative analgesic instruction and prescription reduces early home pain after outpatient surgery: a randomized controlled trial. Can J Anaesth 2021; 69:1033-1041. [PMID: 33982238 DOI: 10.1007/s12630-021-02023-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 02/25/2021] [Accepted: 04/07/2021] [Indexed: 10/21/2022] Open
Abstract
BACKGROUND Home pain remains the most common complication in outpatient surgery. Optimal management requires good information and early availability of analgesics. The main objective of this randomized controlled trial was to compare the effects of pre- vs postoperative analgesic instruction and prescription on postoperative home pain. METHODS Patients were randomized into an anesthesia consultation group (AC group) and a standard postoperative group (POP group). The AC group and the POP group received analgesic prescription and instruction during the anesthesia consultation and after surgery, respectively. The primary outcome was the incidence of home pain on postopertive day one (D1). Home pain was defined by at least one episode with a numeric rating scale score > 3/10 at rest. Treatment compliance and postoperative nausea and vomiting (PONV) were also assessed on D1 and postoperative day 7 (D7). RESULTS One hundred and eighty-six patients were included between May 2017 and May 2018 at Rouen University Hospital, France. Ninety-four patients were randomized to the AC group and 92 to the POP group. On D1, the incidence of pain was 23/94 (24%) in the AC group and 44/92 (48%) in the POP group (P < 0.001). On D1, the rate of treatment compliance was significantly higher in the AC group than in the POP group (85% vs 69%; P = 0.02). There was no statistically significant difference in the incidence of pain or treatment compliance between groups on D7 or in PONV on D1 and on D7. CONCLUSIONS Preoperative analgesic instruction and prescription during anesthesia consultation reduces the incidence of early postoperative home pain in outpatient surgery. TRIAL REGISTRATION www.clinicaltrialsgov (NCT03205189); registered 2 July 2017.
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Affiliation(s)
- Jean Selim
- Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France. .,Normandy Univ, UNIVROUEN, INSERM U1096, 76000 , Rouen, France.
| | - Zoubir Djerada
- Department of Pharmacology, EA3801, SFR CAP-Santé, Reims University Hospital, 51 rue Cognacq-Jay, 51095, Reims, France
| | - Céline Chaventre
- Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France
| | - Thomas Clavier
- Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.,Normandy Univ, UNIVROUEN, INSERM U1096, 76000 , Rouen, France
| | - Bertrand Dureuil
- Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France
| | - Emmanuel Besnier
- Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.,Normandy Univ, UNIVROUEN, INSERM U1096, 76000 , Rouen, France
| | - Vincent Compere
- Department of Anesthesiology and Critical Care, Rouen University Hospital, 1 rue de Germont, 76000, Rouen, France.,Day Surgery Unit, Rouen University Hospital, 76000, Rouen, France
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Albaladejo P, Aubrun F, Samama CM, Jouffroy L, Beaussier M, Benhamou D, Romegoux P, Skaare K, Bosson JL, Ecoffey C. The structure, organisation and perioperative management of ambulatory surgery and anaesthesia in France: Methodology of the SFAR-OPERA study. Anaesth Crit Care Pain Med 2016; 36:307-312. [PMID: 27913269 DOI: 10.1016/j.accpm.2016.10.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Revised: 08/12/2016] [Accepted: 10/04/2016] [Indexed: 11/16/2022]
Abstract
The organization of health care establishments and perioperative care are essential for ensuring the quality of care and safety of patients undergoing outpatient surgery. In order to correctly inventory these organizations and practices, in 2013-2014, the French society of anaesthesia and intensive care organized an extensive practical survey in French ambulatory surgery units entitled the "OPERA" study (Organisation periopératoire de l'anesthésie en chirurgie ambulatoire). From among all of the ambulatory surgery centres listed by the Agences régionales de santé (Regional health agencies, France), 206 public and private centres were randomly selected. A structural (typology, organization) survey and a medical-practice survey (focusing on the management of postoperative pain, nausea and vomiting as well as the prevention of venous thromboembolism) were collected and managed by a prospective audit of practices occurring on two randomly selected days. The latter was further accompanied by an additional audit specifically focussing on ten representative procedures: (1) stomatology surgery (third molar removal); (2) knee arthroscopy; (3) surgery of the abdominal wall (including inguinal hernia); (4) perianal surgery; (5) varicose vein surgery; (6) digestive laparoscopy-cholecystectomy; (7) breast surgery (tumourectomy); (8) uterine surgery; (9) hallux valgus and (10) hand surgery (excluding carpal tunnel). Over the 2 days of observation, 7382 patients were included comprising 2174 patients who underwent one of the procedures from the above list. The analysis of these data will provide an overview of the organization of health establishments, the modalities thus supported and compliance with standards.
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Affiliation(s)
- Pierre Albaladejo
- Department of anaesthesia and intensive care, Grenoble university hospital, avenue Maquis-du-Grésivaudan, 38700 La Tronche, France; Clinical investigation centre, Grenoble university hospital, ThEMAS, TIMC, UMR-CNRS 5525, university Grenoble-Alpes, 38700 La Tronche, France.
| | - Frédéric Aubrun
- Department of anaesthesiology and intensive care, hospices civils de Lyon, La-Croix-Rousse university hospital, 69004 Lyon, France
| | - Charles-Marc Samama
- Department of anaesthesiology and intensive care, Assistance publique-Hôpitaux de Paris, Cochin university hospital, 75014 Paris, France
| | | | - Marc Beaussier
- Department of anaesthesiology and intensive care, Assistance publique-Hôpitaux de Paris, Saint-Antoine university hospital, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France
| | - Dan Benhamou
- Department of anaesthesiology, hôpital Bicêtre, groupe hospitalier, faculté de médecine Paris Sud, AP-HP, 78, rue du Général-Koenig, 94270 Le Kremlin-Bicêtre, France
| | - Pauline Romegoux
- Clinical investigation centre, Grenoble university hospital, ThEMAS, TIMC, UMR-CNRS 5525, university Grenoble-Alpes, 38700 La Tronche, France
| | - Kristina Skaare
- Clinical investigation centre, Grenoble university hospital, ThEMAS, TIMC, UMR-CNRS 5525, university Grenoble-Alpes, 38700 La Tronche, France
| | - Jean-Luc Bosson
- Clinical investigation centre, Grenoble university hospital, ThEMAS, TIMC, UMR-CNRS 5525, university Grenoble-Alpes, 38700 La Tronche, France
| | - Claude Ecoffey
- Department of anaesthesiology and intensive care, Rennes university hospital, 2, rue Henri-Le-Guilloux, 35033 Rennes, France
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Current world literature. Curr Opin Anaesthesiol 2012; 25:743-8. [PMID: 23147670 DOI: 10.1097/aco.0b013e32835b8a43] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chirurgie ambulatoire : le contrôle de la douleur postopératoire n’est pas si simple que cela ! ACTA ACUST UNITED AC 2011; 30:867-8. [DOI: 10.1016/j.annfar.2011.10.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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