Management of Pain and Nausea in Outpatient Surgery yyy Gloria Juarez, RN, PhD,* Carey A. Cullinane, MD, † Tami Borneman, RN, MSN,* Andres Falabella, MD, ‡ Betty R. Ferrell, PhD, FAAN,* Lawrence D. Wagman, MD, § and Michael Lew, MD ‡ y ABSTRACT: The cost associated with surgical procedures has been dramatically decreased by the ability to perform these procedures on an outpatient basis. Pain and nausea, two common symptoms after anesthesia and surgical procedures, are among the greatest concerns for patients and their family members. As a result of the distress and sequelae associ- ated with these symptoms, clinicians have attempted to determine the optimal intraoperative and postoperative symptom management for patients. The purpose of this quality improvement project was to de- scribe the incidence of these symptoms and their management in pa- tients who underwent planned outpatient surgical procedures in a cancer center. A sample of 39 patients were accrued at a comprehen- sive cancer center over a 3-month period. Data were collected at three specific time points (i.e., preoperatively, at 24 hours and at 7 days postoperatively). Postoperative pain and nausea were generally well managed, but improvement was needed in preoperative patient teach- ing, including the topics of drug and nondrug interventions. The methods used in this project have potential application for the mea- surement of other clinical outcomes after outpatient surgical proce- dures. © 2005 by the American Society for Pain Management Nursing Postoperative pain, nausea, and vomiting are common symptoms after surgical procedures and anesthesia, and are among the greatest concerns for patients and their family members. Because of the complications associated with these symptoms, clinicians have attempted to determine the optimal intraoperative and postoperative management of symptoms for patients undergoing surgical procedures requiring anesthesia and conducted on an outpatient basis. Much of the published literature regarding cancer-related pain has focused on the optimal management of chronic pain, evaluation of new drug therapies, and improvements in modes of delivery such as patient-controlled analgesia (Clarke, 1993; Dolin, Cashman, & Bland, 2002; Heye, Foster, Bartlett, & Adkins, 2002; Huang, Cunningham, Laurito, & Chen, 2001; Mathias, 2000). Despite the seemingly growing amount of data related to acute patient management, most From the *Department of Nursing Research and Education, City of Hope National Medical Center, Duarte, California; † Long Beach Memorial Medical Center and Breastlink Medical Group, Inc., Long Beach, California; ‡ Division of Anesthesiology; § Department of General Oncologic Surgery; and ‡ Division of Anesthesiology, City of Hope National Medical Center, Duarte, California. Address correspondence and reprint requests to Gloria Juarez, RN, PhD, City of Hope National Medical Center, Department of Nursing Research and Education, 1500 East Duarte Road, Duarte, CA 91010. E-mail: gjuarez@coh.org 1524-9042/$30.00 © 2005 by the American Society for Pain Management Nursing doi:10.1016/j.pmn.2005.08.001 Original Articles Pain Management Nursing, Vol 6, No 4 (December), 2005: pp 175-181