Influence of a New “Call-Out Algorithm” for Management of Postoperative Pain and Its Side Effects on Length of Stay in Hospital: A Two-Centre Prospective Randomized Trial

Abstract

Background: We recently introduced the efficacy safety score (ESS) as a new “call-out algorithm” for management of postoperative pain and side effects. In this study, we report the influence of ESS recorded hourly during the first 8 hours after surgery on the mobility degree, postoperative nonsurgical complications, and length of hospital stay (LOS). Methods: We randomized 1152 surgical patients into three groups for postoperative observation: (1) ESS group (), (2) Verbal Numeric Rate Scale (VNRS) for pain group (), and (3) an ordinary qualitative observation (Control) group (). An ESS > 10 or VNRS > 4 at rest or a nurse’s observation of pain or adverse reaction to analgesic treatment in the Control group served as a “call-out alarm” for an anaesthesiologist. Results: We found no significant differences in the mobility degree and number of postoperative nonsurgical complications between the groups. LOS was significantly shorter with days (mean ± SD) in the ESS group versus days in the Control group (). Conclusion: Postoperative ESS recording in combination with the possibility to call upon an anaesthesiologist when exceeding the threshold score might have contributed to the reductions of LOS in this two-centre study.