Patient-reported outcomes, postoperative pain and pain relief after day-case surgery (POPPY): short-term peri-operative analgesic use

Anaesthesia. 2026 Mar 29. doi: 10.1111/anae.70211. Online ahead of print.

Abstract

Introduction: An increasing proportion of complex surgical procedures are being performed in the UK as day-cases, with variable and limited follow up. Discharge prescriptions must provide adequate analgesia, while considering the safety of the patient and public, following best practice guidance and good opioid stewardship.

Methods: Data were collected by the POPPY study, a national, prospective, observational study measuring short- and longer-term patient-reported outcomes relating to postoperative pain and pain relief after day-case surgery in adults. We aimed to describe pre-operative and early postoperative analgesia in the first 7 days following surgery alongside describing prescribing practices; analgesic use; patient satisfaction with pain relief; and the need for further healthcare support for pain management.

Results: Of the 7839 patients recruited, 1985 (25.3%) were taking opioid analgesics pre-operatively, of whom 1366 (68.8%) reported pain of more than 3 months duration. After surgery, 3628 (46.4%) patients received opioid analgesics and 1229 (25.9%) reported taking opioid analgesics on day 7. Of those patients prescribed opioids after surgery, 474 (22.8%) reported never taking them. Over three-quarters of patients (3876, 76.7%) reported being satisfied with their analgesia, but 922 (18.2%) sought further help for pain relief, most commonly from their GP. Patients taking postoperative opioids reported higher pain scores; lower satisfaction scores; lower quality of recovery scores; and had higher rates of seeking help to manage pain after discharge.

Discussion: Most patients were satisfied with pain relief after surgery but a large proportion were still taking opioid medications on day 7. Nearly 1 in 5 patients sought additional help for pain relief, potentially constituting a significant burden on community health services. These findings suggest improvements could be made in the systems for day-case patient support after discharge.

Keywords: day surgery; opioid analgesics; pain management; patient reported outcome measures; patient satisfaction.

Plain language summary

What we did: We used information from a large UK study of adults who went home the same day after surgery. We looked at what pain medicines they were given before and after surgery, how much pain they had in the first week, how satisfied they were with their pain relief and whether they needed extra help from doctors or nurses after they went home.

Why did we do it: More people are having complex surgery as day patients and leaving hospital quickly. It is important that they are given the right pain medicine to control pain safely, without using too many strong drugs like opioids. We wanted to understand how pain is treated after day surgery and whether people are coping well once they are at home.

What we found: About one quarter of patients were already taking opioid pain medicines before their surgery, often for long‐lasting pain. After surgery, almost half were given opioids, and about one in four were still taking them a week later. Many people who were given opioids did not actually use them. Most patients were happy with their pain relief, but nearly one in five needed extra help for pain after going home, usually from their GP. People who took opioids after surgery reported more pain, felt less satisfied with their recovery, and were more likely to seek extra help. This shows that while pain care is good for many patients, better support and planning are needed for people after day surgery.