Analgesia

Day case surgery places special demands on the provision of analgesia. The patient must be pain-free but also free from nausea and drowsiness. Hence:

• opiates are used less extensively; fentanil and alfentanil are used because of their rapid metabolism
• long-acting local anaesthetic, e.g. bupivacaine, is added to block the region of surgery, e.g. wound infiltration
• mild-to-moderate pain is controlled with paracetamol or dextropropoxyphene
• moderate-to-severe pain is countered with NSAID's, e.g. diclofenac, or slow-release morphine