Pain management and patient satisfaction following day case arthroscopic shoulder surgery

Abstract

Introduction: Shoulder surgery is known to be extremely painful and yet it has become successful as a day case procedure due to the routine use of brachial plexus blocks. Recent work has delineated that patients may be experiencing pain following discharge once the brachial plexus block has worn off. A service evaluation was undertaken to assess the incidence of post-operative pain in the first 48 hours and patient satisfaction in patients undergoing day case arthroscopic shoulder surgery.  

Methods: This prospective qualitative service evaluation was conducted between January 2019 and June 2019 in patients undergoing day case arthroscopic shoulder surgery on Mondays and Wednesdays with a telephone follow-up interview on Wednesdays and Fridays. 

Results:  In the immediate post-operative period, out of 50 patients, 48 had good pain relief with no pain; 2 patients (4%) required additional analgesia in recovery or on the day-case unit. During the 48-hour follow up we found that 11 patients (30%) reported severe pain and 12 patients (33%) reported moderate pain at rest. Overall, the mean patient satisfaction score was 8.43. Satisfaction scores were higher for patients experiencing mild to moderate pain compared to severe pain at 48 hours post-operatively (P > 0.05). 

Conclusion: We appreciate that patients’ experiences of pain could be improved. We hope to make our post-operative pain protocols more robust and to ensure all patients receive a comprehensive written patient education leaflet about their postoperative pain management.