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Guidelines: Day case and short stay surgery<br />

.....................................................................................................................................<br />

Appendix 4a<br />

Acute pain protocol for adult surgery.<br />

Pain intensity<br />

Discharge medication<br />

Doctor’s signature<br />

(sign one box only)<br />

A None None<br />

B Mild Paracetamol 1 g qds<br />

C Moderate Paracetamol 1 g qds<br />

Plus<br />

Ibuprofen 600 mg qds<br />

C* Moderate<br />

(NSAID intolerant)<br />

Paracetamol 500 mg ⁄ codeine<br />

30 mg 1–2 tabs qds<br />

D Severe Paracetamol 500 mg ⁄ codeine<br />

30 mg 1–2 tabs qds<br />

Plus<br />

Ibuprofen 600 mg qds<br />

D* Severe<br />

(NSAID intolerant)<br />

Paracetamol 1 g qds<br />

Plus<br />

Oral morphine 20 mg qds<br />

Appendix 4b<br />

Pain categories for common procedures in the day surgery unit, to be used<br />

in conjunction with the above.<br />

A B C D<br />

EUA ears<br />

Cystoscopy<br />

Restorative<br />

dentistry<br />

Cataract surgery<br />

Grommets ⁄<br />

T-tube removal ⁄<br />

insertion<br />

Prostate biopsy<br />

Sebaceous cyst surgery<br />

Sigmoidoscopy<br />

Skin lesion surgery<br />

Urethral surgery<br />

Anal surgery<br />

Apicectomy<br />

Arthroscopy<br />

Axillary clearance<br />

Breast lumps<br />

Dupuytren’s contracture<br />

Carpal tunnel<br />

decompression<br />

Cervical ⁄ vulval surgery<br />

Hysteroscopy ⁄ D&C<br />

Middle ear surgery<br />

MUA ± steroid injection<br />

Vaginal sling<br />

Varicose vein surgery<br />

Vasectomy<br />

Non-wisdom tooth<br />

extraction<br />

ACL reconstruction<br />

Circumcision<br />

Endometrial ablation<br />

Laparoscopy<br />

Haemorrhoidectomy<br />

Hernia repair<br />

Joint fusions ⁄ osteotomy<br />

Shoulder surgery<br />

Squint surgery<br />

Testicular surgery<br />

Tonsillectomy<br />

Wisdom tooth extraction<br />

Dental clearance<br />

EUA ⁄ MUA, examination ⁄ manipulation under anaesthesia; ACL, anterior cruciate ligament<br />

Ó 2011 The Authors<br />

Anaesthesia Ó 2011 The Association of Anaesthetists of Great Britain and Ireland 29

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