Reported pain after day surgery: a critical literature review

Background. Despite technological advancements in anaesthesia and analgesia, reported pain levels after day surgery remains high. Whilst it is unrealistic to expect no pain, the level that constitutes 'acceptable' pain remains unclear because of inconsistencies in reporting. These inconsistencies have resulted from different interpretations of what pain is and the use of different measurement tools. Aim. The aim of this paper is to report a study investigating any disparity in reported levels of pain following day surgery, within different specialities and in relation to specific operative procedures. Method. Nursing and health care papers published since 1983 were sought using the keywords: postoperative pain, postoperative complications, pain after day surgery, day surgery, ambulatory surgery, nursing, operation types, operative procedures, surgical procedures, descriptors of pain, pain intensity, verbal descriptor scale, numerical rating scale, visual analogue scale, validity, reliability, design, sample size, data collection methods and their various combinations. Databases searched were Medline, CINAHL, Nursing Collection, Embase, Healthstar, BMJ and several on-line Internet journals, specifically Ambulatory Surgery. The search was restricted to publications in the English language. Findings. Twenty-four papers were identified. Inconsistencies in the reported intensity of pain are highlighted, in relation to different operative procedures and specialities. Data in the papers are based on different descriptors, measurement tools and data collection methods. In many cases, sample size, and validity and reliability can also be questioned. Conclusions. There is a disparity in reported levels of pain after day surgery. It is important that a unified day surgery pain measurement strategy is established, so that patients can be informed about the intensity of pain that they are likely to experience following specific procedures.