Factors Impacting Readiness to Discharge Time from Recovery Room after Laparoscopic Cholecystectomy
Keywords:
Anxiety, abdominal distension, information need, laparoscopic cholecystectomy, postoperative recoveryAbstract
Aim: To evaluate the relationships between preoperative anxiety, preoperative information need, bodymass index, operative time, abdominal distension and discharge readiness from the recovery room in the patient
underwent laparoscopic cholecystectomy.
Methods: The study involved 126 patients who underwent laparoscopic cholecystectomy. The data
collected were the Amsterdam Preoperative Anxiety and Information Scale, abdominal distension level record
form and White’s fast-track recovery score. Descriptive statistics and Pearson product-moment correlations
were employed for data analysis.
Results: Most of the subjects were female (68.3%) with an average age of 55.5 ± 15.3 years. Twenty seven
percent of the subjects were anxious. The average level of subjects’ preoperative information need was 35%.
Forty nine percent of the subjects had a normal body mass index. The mean operative time was 60.7 ± 23.6
minutes. Fifty six percent of the subjects had abdominal distension in recovery period. Both preoperative
anxiety and abdominal distension had moderate significant correlations with readiness time to discharge from
the recovery room (r = 0.64, p <0.01 and r = 0.63, p <0.01, respectively). Similarly, preoperative information
need and body mass index had significant positive correlations with readiness time to discharge from the
recovery room (r = 0.32, p <0.01 and r = 0.20, p <0.05, respectively). However, the operative time was not
correlated with the time to discharge from the recovery room.
Conclusion: Healthcare providers should pay more attention to reducing preoperative anxiety by
providing more information to reduce anxiety and information about cause of abdominal distension that may
occur. They should also relieve postoperative anxiety in order to promote faster and better postoperative
recovery period.
References
1. Bellows CF, Berger DH, Crass RA. Management of gallstone.
Am Fam Physician 2005;72:637-42.
2. Hamliton EC, Jones DB. Cholecystectomy. In: Jones DB, Wu
JS, Soper NJ, editors. Laparoscopic surgery principles and
procedure. 2nd ed. New York: Marcel Dekker; 2004.
3. Department of surgery. Annual report. Faculty of Medicine
Siriraj Hospital; 2008.
4. Breitenstein S, Nocito A, Puhan M, Held U, Weber M, Clavien
PA. Robotic-assisted versus laparoscopic cholecystectomy:
Outcome and cost analyses of a case-matched control
study. Ann Surg 2008;247:987-93.
5. Jensen K, Kehlet H, Lund CM. Post-operative recovery
profile after laparoscopic cholecystectomy: a prospective,
observational study of a multimodal anesthetic regime.
Acta Anaesthesiol Scand 2007;51:464-71.
6. Akkurt BCO, Temiz M, Inanoglu K, Aslan A, Turhanoglu S,
Asfuroglu Z, et al. Comparison of recovery characteristics,
postoperative nausea and vomiting and gastrointestinal
motility with total intravenous anesthesia with propofol versus
inhalation anesthesia with desflurane for laparoscopic
cholecystectomy: A randomized controlled study. Curr
Ther Res Clin Exp 2009;70:94-103.
7. Nursal TZ, Yildirim S, Tarim A, Noyan T, Poyraz P, Tuna N, et al.
Effect of drainage on postoperative nausea, vomiting and
pain after laparoscopic cholecystectomy. Langenbecks
Arch Surg 2003;388:95-100.
8. Wheeler M, Oderda G, Ashburn M, Lipman A. Adverse
events associated with postoperative opioid analgesia: A
systematic review. J Pain 2002;3:159-80.
9. Thomson A J M, Abbott JA, Lenart M, Willson F, Vancaillie TG,
Bennett M J. Assessment of a method to expel intraperitoneal
gas after gynecologic laparoscopy. J Min Inv Gynecol
2005;12:125-9.
10. Karagulle E, Turk E, Dogan R, Ekici Z, Dorgan R, Moray G. The
effect of different abdominal pressure on pulmonary function
test results in laparoscopic cholecystectomy. Surg Laparosc
Endosc Percutan Tech 2008;18:329-33.
11. De Cosmo G, Congedo E, Lai C, Primieri P, Dottarelli A,
Aceto P. Preoperative psychologic and demographic
predictors of pain perception and tramadol consumption
using intravenous patient-controlled analgesia. Clin J Pain
2008;2:399-405.
12. Granot M, Ferber SG. The roles of pain catastrophizing and
anxiety in the prediction of postoperative pain intensity: A
prospective study. Clin J Pain 2005;21:439-45.
13. Rhudy J L, Meagher M W. Fear and anxiety: Divergent
effects on human pain thresholds. Pain 2000;84:65-75.
14. Moerman N, Van Dam FS, Muller MJ, Oosting H. The
amsterdam preoperative anxiety and information scale
(APAIS). Anesth Analg 1996;82:445-51.
15. Henderson A, Zernike W. A study of the impact of discharge
information for surgical patients. J Adv Nurs 2001;35:1-7.
16. Lithner M, Zilling T. Pre- and postoperative information need.
Patient Education and Counseling 2000;40:29-37.
17. White PF, Song D. New criteria for fast-tracking after
outpatient anesthesia: A comparison with the modified
aldrete’s scoring system. Anesth Analg 1999;88:1069-72.
18. Bestas A, Onal SA, Bayar MK, Yildirim A, Aygen E. Effects of
ondansetron and granisetron on postoperative nausea
and vomiting in adult patients undergoing laparoscopic
cholecystectomy: A randomized, double-blind, placebo-
controlled clinical trial. Curr Ther Res Clin Exp 2007;68:303-
12.
19. Bisgaard T, Klarskov B, Kehlet H, Rosenberg J. Preoperative
dexamethasone improves surgical outcome after
laparoscopic cholecystectomy. Ann Surg 2003; 238: 651-60.
20. Nikumb VB, Banerjee A, Kaur G, Chaudhury S. Impact of
doctor-patient communication on preoperative anxiety.
Indust Psych J 2009;18:19-21.
21. Sirinan C, Rungreungvanich M, Vijitpawan A,
Morkchareonpong C. Preanesthetic anxienty assessment:
HADS versus APAIS. Thai J Anesthesiol 2000;26:155-61.
22. Weinstock LS. Gender differences in the presentation and
management of social anxiety disorder. J Clin Psych 1999;
60:9-13.
23. Rosen S, Svensson M, Nilsson U. Calm or not calm: The
question of anxiety in the perianesthesia patient. J
PeriAnesthesia Nursing 2008;23:237-46.
24. Caumo W, Schmidt AP, Schneider CN, Bergmann J, Iwamoto
CW, Bandeira D, et al. Risk factors for preoperative anxiety
in adults. Acta Anaesthesiol Scand 2000;45:298-307.
25. Guyton AC, Hall JE (Eds.). Textbook of medical physiology.
Philadelphia: Elsevier Saunders; 2006.
26. Mordiffi SZ, Tan SP, Wong MK. Information provided to
surgical patients versus information needed. AORN J 2003;
77:546-62.
27. Baerdemaeker LEC, Mortier EP, Struys, MRF.
Pharmacokinetics in obese patients. Contin Educ Anaesth
Crit Care Pain 2004;4:152-5.
28. Casati A, Putzu M. Anesthesia in the obese patient: Pharmacokinetic
considerations. J Clin Anesth 2005;17:134-45.
29. Lee JB, Winstead PS, Cook AM. Pharmacokinetic alterations
in obesity. Orthopedics 2006;29:984-8.
30. Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity
on the pharmacokinetics of drug in humans. Clin
Pharmacokinet 2010;49:71-87.
31. Chakraboty GP, Bhattacharya P. Gastric distension during
laparoscopic cholecystectomy: comparison between ETT
and PLMA. Int J Anesthesiol 2007.
32. Ure BM, Troidl H, Spangenberger W, Dietrich A, Lefering R,
Neugebuer, E. Pain after laparoscopic cholecystectomy:
Intensity and localization of pain and analysis of predictors
in preoperative symptoms and intraoperative event. Surg
Endosc 1994;8:90-6.
Am Fam Physician 2005;72:637-42.
2. Hamliton EC, Jones DB. Cholecystectomy. In: Jones DB, Wu
JS, Soper NJ, editors. Laparoscopic surgery principles and
procedure. 2nd ed. New York: Marcel Dekker; 2004.
3. Department of surgery. Annual report. Faculty of Medicine
Siriraj Hospital; 2008.
4. Breitenstein S, Nocito A, Puhan M, Held U, Weber M, Clavien
PA. Robotic-assisted versus laparoscopic cholecystectomy:
Outcome and cost analyses of a case-matched control
study. Ann Surg 2008;247:987-93.
5. Jensen K, Kehlet H, Lund CM. Post-operative recovery
profile after laparoscopic cholecystectomy: a prospective,
observational study of a multimodal anesthetic regime.
Acta Anaesthesiol Scand 2007;51:464-71.
6. Akkurt BCO, Temiz M, Inanoglu K, Aslan A, Turhanoglu S,
Asfuroglu Z, et al. Comparison of recovery characteristics,
postoperative nausea and vomiting and gastrointestinal
motility with total intravenous anesthesia with propofol versus
inhalation anesthesia with desflurane for laparoscopic
cholecystectomy: A randomized controlled study. Curr
Ther Res Clin Exp 2009;70:94-103.
7. Nursal TZ, Yildirim S, Tarim A, Noyan T, Poyraz P, Tuna N, et al.
Effect of drainage on postoperative nausea, vomiting and
pain after laparoscopic cholecystectomy. Langenbecks
Arch Surg 2003;388:95-100.
8. Wheeler M, Oderda G, Ashburn M, Lipman A. Adverse
events associated with postoperative opioid analgesia: A
systematic review. J Pain 2002;3:159-80.
9. Thomson A J M, Abbott JA, Lenart M, Willson F, Vancaillie TG,
Bennett M J. Assessment of a method to expel intraperitoneal
gas after gynecologic laparoscopy. J Min Inv Gynecol
2005;12:125-9.
10. Karagulle E, Turk E, Dogan R, Ekici Z, Dorgan R, Moray G. The
effect of different abdominal pressure on pulmonary function
test results in laparoscopic cholecystectomy. Surg Laparosc
Endosc Percutan Tech 2008;18:329-33.
11. De Cosmo G, Congedo E, Lai C, Primieri P, Dottarelli A,
Aceto P. Preoperative psychologic and demographic
predictors of pain perception and tramadol consumption
using intravenous patient-controlled analgesia. Clin J Pain
2008;2:399-405.
12. Granot M, Ferber SG. The roles of pain catastrophizing and
anxiety in the prediction of postoperative pain intensity: A
prospective study. Clin J Pain 2005;21:439-45.
13. Rhudy J L, Meagher M W. Fear and anxiety: Divergent
effects on human pain thresholds. Pain 2000;84:65-75.
14. Moerman N, Van Dam FS, Muller MJ, Oosting H. The
amsterdam preoperative anxiety and information scale
(APAIS). Anesth Analg 1996;82:445-51.
15. Henderson A, Zernike W. A study of the impact of discharge
information for surgical patients. J Adv Nurs 2001;35:1-7.
16. Lithner M, Zilling T. Pre- and postoperative information need.
Patient Education and Counseling 2000;40:29-37.
17. White PF, Song D. New criteria for fast-tracking after
outpatient anesthesia: A comparison with the modified
aldrete’s scoring system. Anesth Analg 1999;88:1069-72.
18. Bestas A, Onal SA, Bayar MK, Yildirim A, Aygen E. Effects of
ondansetron and granisetron on postoperative nausea
and vomiting in adult patients undergoing laparoscopic
cholecystectomy: A randomized, double-blind, placebo-
controlled clinical trial. Curr Ther Res Clin Exp 2007;68:303-
12.
19. Bisgaard T, Klarskov B, Kehlet H, Rosenberg J. Preoperative
dexamethasone improves surgical outcome after
laparoscopic cholecystectomy. Ann Surg 2003; 238: 651-60.
20. Nikumb VB, Banerjee A, Kaur G, Chaudhury S. Impact of
doctor-patient communication on preoperative anxiety.
Indust Psych J 2009;18:19-21.
21. Sirinan C, Rungreungvanich M, Vijitpawan A,
Morkchareonpong C. Preanesthetic anxienty assessment:
HADS versus APAIS. Thai J Anesthesiol 2000;26:155-61.
22. Weinstock LS. Gender differences in the presentation and
management of social anxiety disorder. J Clin Psych 1999;
60:9-13.
23. Rosen S, Svensson M, Nilsson U. Calm or not calm: The
question of anxiety in the perianesthesia patient. J
PeriAnesthesia Nursing 2008;23:237-46.
24. Caumo W, Schmidt AP, Schneider CN, Bergmann J, Iwamoto
CW, Bandeira D, et al. Risk factors for preoperative anxiety
in adults. Acta Anaesthesiol Scand 2000;45:298-307.
25. Guyton AC, Hall JE (Eds.). Textbook of medical physiology.
Philadelphia: Elsevier Saunders; 2006.
26. Mordiffi SZ, Tan SP, Wong MK. Information provided to
surgical patients versus information needed. AORN J 2003;
77:546-62.
27. Baerdemaeker LEC, Mortier EP, Struys, MRF.
Pharmacokinetics in obese patients. Contin Educ Anaesth
Crit Care Pain 2004;4:152-5.
28. Casati A, Putzu M. Anesthesia in the obese patient: Pharmacokinetic
considerations. J Clin Anesth 2005;17:134-45.
29. Lee JB, Winstead PS, Cook AM. Pharmacokinetic alterations
in obesity. Orthopedics 2006;29:984-8.
30. Hanley MJ, Abernethy DR, Greenblatt DJ. Effect of obesity
on the pharmacokinetics of drug in humans. Clin
Pharmacokinet 2010;49:71-87.
31. Chakraboty GP, Bhattacharya P. Gastric distension during
laparoscopic cholecystectomy: comparison between ETT
and PLMA. Int J Anesthesiol 2007.
32. Ure BM, Troidl H, Spangenberger W, Dietrich A, Lefering R,
Neugebuer, E. Pain after laparoscopic cholecystectomy:
Intensity and localization of pain and analysis of predictors
in preoperative symptoms and intraoperative event. Surg
Endosc 1994;8:90-6.
Downloads
Published
2011-06-30
How to Cite
1.
Tuvayanon W, Toskulkao T, Asdornwised U, Akaraviputh T. Factors Impacting Readiness to Discharge Time from Recovery Room after Laparoscopic Cholecystectomy. Thai J Surg [Internet]. 2011 Jun. 30 [cited 2024 Dec. 23];32(2). Available from: https://he02.tci-thaijo.org/index.php/ThaiJSurg/article/view/227242
Issue
Section
Original Articles
License
Articles must be contributed solely to The Thai Journal of Surgery and when published become the property of the Royal College of Surgeons of Thailand. The Royal College of Surgeons of Thailand reserves copyright on all published materials and such materials may not be reproduced in any form without the written permission.
