Postoperative pain and cure of trapeziometacarpal osteoarthritis of thumb following ambulatory surgery.

Objective: The course of pain and the incidence of the side effects from an algesics were evaluated for 15 days in 26 consecutive outpatients who under went a surgical cure of trapeziometacarpal osteoarthritis of the thumb unde r regional block. Study design: Prospective study. Methods: The analgesic regimen prescribed at discharge consisted on a regul ar administration of a combination of ketoprofen (50 mg.6.h(-1)) plus the a ssociation of acetaminophen and propoxyphene (two tablets.6.h(-1)). Patient s were asked to evaluate their pain using a numerical rating scale graduate d from 0 to 10. Data were collected during a telephone interview at day 4, 8 and 15. Results: Overall, patients scrupulously followed the medical prescription. At day four, 80% of patients still needed analgesics. The mean period durin g which NSAID, acetaminophen and propoxyphene were maintained was 4 and 6 d ays respectively. Fifty percent of patients reported severe pain during pos toperative day 1 and 2. Moderate pain was reported at day 3 and 4 in respec tively 54% and 42% of cases. Beyond this period, most patients indicated pa in of weak intensity (71% at day 8). Epigastric pain has been noticed for 2 7% of patients. Conclusion: The surgical correction of trapeziometacarpal osteoarthritis of the thumb is frequently performed according to an ambulatory setting. The fact that 50% of patients reported severe pain during the early postoperati ve period emphasize the inadequacy of our postoperative pain management for this surgical procedure. (C) 2000 Editions scientifiques et medicates Else vier SAS.