Pain Experienced by Laparoscopic Donor Nephrectomy Patients in an Academic Medical Setting

Abstract

Context Since 1996, 414 laparoscopic live donor nephrectomy procedures have been completed at our institution. Although this procedure has gained acceptance within the past 5 years, little is known about its nursing implications. Objective The purpose of this performance improvement project was to identify pain management practices, satisfaction levels, and clinical outcomes among patients undergoing laparoscopic live donor nephrectomy. Patients Data were collected for a convenience sample of 70 patients for 18 months. Intervention Several pain management methods were used, including patient-controlled analgesia and intramuscular and oral medications. Results Pain ratings ranged from 3.2 to 3.8 for the first 36 hours postoperatively. The mean pain level did not differ significantly between pain regimes. At discharge, patients perceived a mean overall pain level of 5.0 but anticipated a pain level of 6.1. A significant negative correlation between satisfaction and pain rating also was noted. Conclusions Opportunities exist to standardize current regimens of pain medications and address pain level and treatment 24 hours postoperatively.