We retrospectively included patients who underwent
day surgery under general or
regional anesthesia and those who underwent
local anesthesia in Rouen University Hospital from January 2018 to February 2020. Data collected were moderate-to-severe
pain reports defined as numeric rating scale (NRS)>3/10 at 1 day (secondary end point) and 7 days (primary end point) after surgery. These data were collected using a semi-intelligent SMS text messaging platform to follow up with the patient at home after
ambulatory surgery. Univariate and multivariate analyses were performed to analyze the risk factors for
pain.
RESULTS: We analyzed 6099 patients. On the day after the surgery, 5.2% (318/6099) of the patients presented with moderate-to-severe
pain: 5.9% (248/4187) in the general or
regional anesthesia group and 3.7% (70/1912) in the
local anesthesia group. At 7 days after the surgery, 18.6% (1135/6099) of the patients presented with moderate-to-severe
pain, including 21.3% (892/4187) of the patients in the general or
regional anesthesia group and 12.7% (243/1912) of the patients in the
local anesthesia group. General surgery (odds ratio [OR] 1.54, 95% CI 1.23-1.92; P<.01) and
orthopedic surgery (OR 1.66, 95% CI 1.42-1.94; P<.01) were associated with more late
postoperative pain risk. Male gender (OR 0.66, 95% CI 0.57-0.76; P<.01), ophthalmology surgery (OR 0.51, 95% CI 0.42-0.62; P<.01), and
gynecologic surgery (OR 0.67, 95% CI 0.50-0.88; P=.01) were associated with less late
postoperative pain risk. The rate of emergency consultation or
rehospitalization at 7 days after the surgery was 11.1% (679/6099). Late
postoperative pain (OR 2.54, 95% CI 1.98-3.32; P<.001), general surgery (OR 2.15, 95% CI 1.65-2.81; P<.001), and urology surgery (OR 1.62, 95% CI 1.06-2.43; P=.02) increased the risk of emergency consultation or
rehospitalization.
Orthopedic surgery (OR 0.79, 95% CI 0.63-0.99; P=.04) and electroconvulsive therapy (OR 0.43, 95% CI 0.27-0.65; P<.001) were associated with less rates of emergency consultation or
rehospitalization.
CONCLUSIONS: