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Table 3 Daily assessment form: from operation day to discharge day

From: Electroacupuncture for postoperative pain and gastrointestinal motility after laparoscopic appendectomy (AcuLap): study protocol for a randomized controlled trial

 

Operation

POD1

POD2

POD3

POD4

POD5

…….

Discharge

Pain score (VAS)

1) Morning: ___

        

2) Mid-day: ___

3) Evening: ___

IV analgesics

___/day

        

Nausea/vomiting

Nausea: No/Yes(___/day) Vomiting: No/Yes(___/day)

        

Bowel motility (bowel sound/minute)

1) Morning: __/min

        

2) Mid-day: __/min

3) Evening: __/min

Intestinal passage

Flatus: Yes(___/day)/No

        

Stool: Yes(___/day)/No

Tolerability to liquid

Yes/No

        

Tolerability to soft diet

Yes/No

        

Mobilization and self-care

Yes/No

        

Postoperative complications (Accordion classification)

No/ 1/ 2/ 3/ 4/ 5

        

Fulfillment of defined discharge criteria

___/total(5)

        

Patient’s agreement to discharge

Yes/No

        
  1. VAS visual analogue scale, POD postoperative day