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Postoperative Pain Treatment in Day Surgery: A Quality Improvement Study Examining the Needs of Opioid and Effects of Oxycodone and Morphine

Background: There is sparse literature providing evidence for postoperative pain treatment in day surgery and for differences between morphine and oxycodone. Objectives: The objectives of this study were to examine the need for opioids and the effects of morphine versus oxycodone for pain relief and side effects at home after day surgery. Methods: This study was a prospective observational study with a quasi-randomized approach. Data consisted of self-reported three-day registration of use and the effects of the opioids, their side effects, and patient satisfaction with regards to pain treatment in a Danish day surgery conducting orthopedic and abdominal surgery. The outcomes, including the use of opioids, self-reported pain relief, and related side effects (nausea, fatigue, dizziness, and skin itchiness) were measured by a numeric rating scale and patient satisfaction with regards to pain treatment. Results: Out of the 199 included day surgery patients, 162 (81%) returned self-reported postoperative data. A total of 73% of the patients had used opioids an average of 4 times (range 1 16). Median levels of nausea, dizziness, and skin itching were 0 (IQR 0 3) whereas the median level of fatigue was 3 (IQR 0 6). More than 90% of the patients were satisfied or very satisfied with their postoperative pain treatment. No statistically significant differences were found between oxycodone and morphine in regard to onset time, level, duration of pain treatment, and the experienced side effects. Conclusions: Three-quarters of the patients used opioids after day surgery with a substantially varied number of doses. Few patients experienced substantial side effects, and the patients were generally satisfied with their pain treatment. No significant difference was found between oxycodone and morphine. The need for opioids after day surgery varies substantially and further investigations on individuals and follow-up are needed.