Effect of Ultrasound-guided Superficial Parasternal Intercostal Plane Block on The Quality of Recovery in Patients Undergoing Sternotomy Cardiac Surgery / 中山大学学报(医学科学版)

ObjectiveThis study aims to explore the effect of ultrasound-guided superficial parasternal intercostal plane block on the quality of recovery and postoperative analgesia in patients undergoing sternotomy cardiac surgery. MethodsA total of 64 patients undergoing sternotomy cardiac surgery were selected for this study. They were randomly divided into two groups： one group received a superficial parasternal intercostal plane block with ropivacaine （the ropivacaine group）， while the other was given normal saline （the normal saline group）. The primary outcome was the Quality of Recovery-15 （QoR-15） score on postoperative day 1 in both groups， accompanied by a comparative analysis of the pain score and opioid usage. ResultsCompared with the normal saline group， the ropivacaine group exhibited a significantly higher QoR-15 score on postoperative day 1［（89.60±13.24） vs （81.18±12.78）， P=0.012］. The numerical rating scale at rest was significantly lower［（3.03±0.72） vs （4.26±0.93）， P<0.001］， and the numerical rating scale during coughing was also significantly reduced ［（4.40±0.89） vs （5.44±1.05）， P<0.001］. Concurrently， the cumulative morphine equivalent consumption during the initial 24 h postoperatively was significantly lower in patients who were administered the ropivacaine ［14.15 （4.95～30.00） mg vs 40.50 （19.25～68.18） mg， P=0.002］， and there was also a notable decrease in the rescue analgesia ［0.00 （0.00～0.00） mg vs 0.00 （0.00～100.00） mg， P=0.007］. ConclusionUltrasound-guided superficial parasternal intercostal plane block can significantly enhance the overall quality of recovery in patients undergoing sternotomy cardiac surgery on postoperative day 1. The technique contributes to improved postoperative analgesic effects and a reduction in opioid usage， thereby facilitating early postoperative recovery.

Analgesic effect of buccal acupuncture on patients after lumbar spinal fusion: a randomized controlled trial / 中国针灸

OBJECTIVE@#To observe the effect of buccal acupuncture on pain after lumbar spinal fusion.@*METHODS@#Sixty patients undergoing lumbar spinal fusion were randomly divided into an observation group (30 cases, 1 case dropped off) and a control group (30 cases, 1 case was eliminated). The patients in the control group were treated with routine anesthesia. On the basis of the control group, the patients in the observation group were treated with buccal acupuncture at bilateral back point, waist point, and sacral point for 30 min per treatment. The first acupuncture was given before anesthesia induction, and then once a day postoperation for two days, totally 3 treatments. The dosage of sufentanil, the number of remedial analgesia, and the incidence of nausea and vomiting within 48 h after surgery were compared between the two groups; rest and motion visual analogue scale (VAS) scores at 2 (T1), 8 (T2), 12 (T3), 24 (T4), and 48 (T5) h after surgery were observed; the quality of recovery-15 scale (QoR-15) at 24 and 48 h after surgery were evaluated.@*RESULTS@#The dosage of sufentanil and the number of remedial analgesia within 48 h after surgery in the observation group were lower than those in the control group (P<0.01). There was no significant statistically difference in rest and motion VAS scores between the two groups in T1, T2, T3, T4 and T5 (P>0.05). The QoR-15 scores in the observation group at 24 and 48 h after surgery were higher than those in the control group (P<0.01). The incidence of nausea in the observation group was lower than that in the control group (P<0.05).@*CONCLUSION@#Buccal acupuncture could reduce the amount of postoperative analgesic drugs of patients after lumbar spinal fusion, and promote early postoperative recovery.

Evaluation of lignocaine, dexmedetomidine, lignocaine-dexmedetomidine infusion on pain and quality of recovery for robotic abdominal hysterectomy: a prospective randomized controlled trial

Abstract Background: Acute postoperative pain is associated with poor quality of recovery after surgery. Perioperative use of intravenous lignocaine or dexmedetomidine have demonstrated better pain control, early return of bowel function, and effects on quality of recovery. Methods: Ninety-six women planned for elective robotic abdominal hysterectomy were randomized into four groups. Groups received lignocaine infusion (1.5 mg.kg−1 loading, 2 mg.kg−1.h−1 infusion) (Group I), dexmedetomidine infusion (1 µg.kg−1 loading, 0.6 µg.kg−1.h−1 infusion) (Group 2), lidocaine (1.5 mg.kg−1 loading, 2 mg.kg−1.h−1 infusion), and dexmedetomidine infusions (1 µg.kg−1 loading, 0.5 µg.kg−1.h−1 infusion) (Group 3), and normal saline 10 mL loading, 1 mL.kg−1.h−1 infusion) (Group 4). Primary outcome was visual analogue pain scores at 1, 2, 4, 12, and 24 hours after surgery. Secondary outcomes included postoperative fentanyl requirement, time of return of bowel sounds and flatus, QoR15 score on day 1, 2, and discharge. Results The VAS was significantly lower in Groups 2 and 3 compared to Groups 1 and 4. Total postoperative fentanyl consumption in the first 24 hours was 256.25 ± 16.36 mcg (Group 1), 177.71 ± 16.81 mcg (Group 2), 114.17 ± 16.19 mcg (Group 3), and 304.42 ± 31.26 mcg (Group 4), respectively. Time to return of bowel sounds and passage of flatus was significantly shorter in Groups 2 and 3 (p < 0.01). QoR15 scores after surgery were higher in Group 3 compared to Groups 1, 2, and 4, (p < 0.01) respectively. Conclusion: Combined infusion of lignocaine and dexmedetomidine significantly decreased postoperative pain, fentanyl consumption, and improved quality of recovery score after surgery in patients undergoing Robotic abdominal hysterectomy.

Ultrasound-Guided Continuous Thoracic Paravertebral Block Improves Patient's Quality of Recovery After Open Hepatectomy: A Randomized, Double-Blind, Placebo-Controlled Trial / 中国医学科学杂志(英文版)

Background Ultrasound-guided continuous thoracic paravertebral block can provide pain-relieving and opioid-sparing effects in patients receiving open hepatectomy. We hypothesize that these effects may improve the quality of recovery (QoR) after open hepatectomy. Methods Seventy-six patients undergoing open hepatectomy were randomized to receive a continuous thoracic paravertebral block with ropivacaine (CTPVB group) or normal saline (control group). All patients received patient-controlled intravenous analgesia with morphine postoperatively for 48 hours. The primary outcome was the global Chinese 15-item Quality of Recovery score on postoperative day 7, which was statistically analyzed using Student's t-test. Results Thirty-six patients in the CTPVB group and 37 in the control group completed the study. Compared to the control group, the CTPVB group had significantly increased global Chinese 15-item Quality of Recovery scores (133.14 ± 12.97 vs. 122.62 ± 14.89, P = 0.002) on postoperative day 7. Postoperative pain scores and cumulative morphine consumption were significantly lower for up to 8 and 48 hours (P < 0.05; P = 0.002), respectively, in the CTPVB group. Conclusion Perioperative CTPVB markably promotes patient's QoR after open hepatectomy with a profound analgesic effect in the early postoperative period.

Effects of different postoperative analgesic strategies on postoperative neurocognitive function and quality of recovery in elderly patients undergoing one lung ventilation / 南方医科大学学报

OBJECTIVE@#To evaluate the effects of different postoperative analgesic strategies on neurocognitive function and quality of recovery in elderly patients at 7 days after thoracic surgery with one lung ventilation.@*METHODS@#Ninety elderly patients undergoing video-assisted thoracic surgery were randomized into 3 groups (@*RESULTS@#The patients in TA and EA groups had significantly higher MMSE scores and lower incidence of postoperative neurocognitive dysfunction (PNCD) than those in GA group without significant difference between the former two groups. At 7 days after the surgery, serum levels of S100-β and MMP-9 were significantly higher in GA group than in TA and EA group, and did not differ significantly between the latter two groups. QoR-40 scores were significantly higher in TA and EA groups than in GA group, and were higher in TA group than in EA group. The chest intubation time and length of hospital stay were significantly shorter in TA and EA groups than in GA group.@*CONCLUSIONS@#In elderly patients undergoing surgeries with one lung ventilation, general anesthesia combined with either postoperative continuous thoracic paravertebral block or epidural analgesia can significantly improve postoperative neurocognitive function and quality of recovery, but continuous thoracic paravertebral block analgesia can be more advantageous for improving postoperative quality of recovery.

Evaluation of early recovery quality in elderly patients with gastrointestinal tumor resection by quality of recovery-40 questionnaire / 中国医师进修杂志

Objective To evaluate the influencing factors and early recovery quality in elderly patients with gastrointestinal tumor resection by the quality of recovery-40 questionnaire (QoR-40 questionnaire). Methods One hundred and forty- two elderly patients who had underwent gastrointestinal tumor resection from February to June 2017 were selected. The patients were over 65 years old. Their body mass index was (22.98 ± 3.20) kg/m2, and American Society of Anesthesilogists (ASA) wasⅡorⅢgrade. The patients were assessed with QoR-40 questionnaire on the first and second day after operation, and the factors affecting the total score of QoR-40 questionnaire on the first and second day after operation were analyzed. Results Compared with those on the first day after operation, the scores of emotional status, physical comfort, psychological support, physical independence, pain and total score of QoR-40 questionnaire on the second day after operation were significantly higher: 42 (39, 43) scores vs. 40 (38, 42) scores, 53 (52, 54) scores vs. 52 (50, 53) scores, 35 (35, 35) scores vs. 35 (34, 35) scores, 15 (13, 15) scores vs. 14 (12, 15) scores, 34 (33, 35) scores vs. 33 (32, 34) scores and 178 (173, 182) scores vs. 174 (169, 177) scores, and there were statistical differences (P<0.01). On the first day after operation, the total score of the QoR-40 questionnaire was related with the type of operation (P<0.05), and it was not related with age, sex and anesthesia (P>0.05);on the second day after operation, the total score of QoR-40 questionnaire was related with age and operation type (P<0.05), and it was not related with sex and anesthesia (P > 0.05). Conclusions The early postoperative period score of QoR-40 questionnaire in patients with colorectal tumor resection and age less than 70 years old is higher, and the recovery quality after operation is relatively good, suggesting that the operation type and age may be an important factor affecting the early recovery quality of the elderly patients with gastrointestinal tumor resection.

Evaluation of the quality of recovery and the postoperative health status after elective surgery / Avaliação da qualidade da recuperação e do estado de saúde no pós-operatório de cirurgias eletivas

Abstract Purpose: Postoperative recovery is a complex process with physiologic, functional, and psychologic dimensions. Postoperative quality of recovery is considered as a crucial outcome following surgery and anesthesia. The objective of this study was to assess and compare the quality of postoperative recovery and health status before and after surgery, in patients undergoing elective surgery. Methods: This observational, prospective study was conducted on patients proposed for elective surgery. Evaluation of postoperative recovery was performed using the Postoperative Quality of Recovery Scale and health status was assessed by applying the EuroQol assessing problems in five dimensions: mobility, personal care, usual activities, pain/discomfort, and anxiety/depression, and the World Health Organization Disability Assessment Schedule 2.0. Poor quality of recovery was defined as recovery in fewer than two domains at postoperative Day 1 in the Postoperative Quality of Recovery Scale. Results: Before surgery (D0), patients with poor quality of recovery had median Visual Analog Scale scores in EuroQol similar to those of patients without poor quality of recovery, but they had more problems in the mobility, usual activities, pain/discomfort, and anxiety/depression dimensions. At 3 months after surgery, patients with poor quality of recovery had median Visual Analog Scale scores in EuroQol similar to those of patients without poor quality of recovery, but they maintained more problems in the pain/discomfort dimension. Patients with poor quality of recovery scored significantly higher on the World Health Organization Disability Assessment Schedule 2.0 scale at baseline, although the results were similar at 3 months. Conclusions: Patients with poor quality of recovery had the worst health status at D0. Evaluation at 3 months indicated similar rates of problems in EuroQol (except for pain/discomfort) and World Health Organization Disability Assessment Schedule 2.0 scores were similar.

Resumo Objetivo: A recuperação pós-operatória é um processo complexo com dimensões fisiológicas, funcionais e psicológicas. A qualidade da recuperação pós-operatória é considerada um resultado crucial após cirurgia e anestesia. O objetivo deste estudo foi avaliar e comparar a qualidade da recuperação pós-operatória e o estado de saúde antes e depois da cirurgia em pacientes submetidos à cirurgia eletiva. Métodos: Este estudo observacional prospectivo foi feito com pacientes agendados para cirurgia eletiva. A avaliação da recuperação pós-operatória foi feita com a Escala de Qualidade da Recuperação Pós-Operatória (Postoperative Quality of Recovery Scale) e o estado de saúde foi avaliado com a aplicação do EuroQol, que analisa problemas em cinco dimensões (mobilidade, cuidados pessoais, atividades habituais, dor/desconforto e ansiedade/depressão) e a ferramenta para medida de incapacidade desenvolvida pela Organização Mundial da Saúde (World Health Organization Disability Assessment Schedule 2.0). Má qualidade de recuperação foi definida como uma recuperação em menos de dois domínios da Escala de Qualidade da Recuperação Pós-Operatória no primeiro dia (D1) de pós-operatório. Resultados: Antes da cirurgia (D0), os pacientes com má qualidade de recuperação apresentaram escores medianos na escala visual analógica semelhantes aos dos pacientes sem má qualidade de recuperação, mas apresentaram mais problemas nas dimensões mobilidade, atividades habituais, dor/desconforto e ansiedade/depressão. No terceiro mês após a cirurgia, os pacientes com má qualidade de recuperação apresentaram escores na escala visual analógica medianos no EuroQol semelhantes aos dos pacientes sem má qualidade de recuperação, mas apresentaram mais problemas na dimensão dor/desconforto. Os escores World Health Organization Disability Assessment Schedule 2.0 dos pacientes com má qualidade de recuperação foram significativamente maiores no início do estudo, embora os resultados tenham sido semelhantes no terceiro mês. Conclusões: Os pacientes com má qualidade de recuperação apresentaram o pior estado de saúde no D0. A avaliação no terceiro mês indicou taxas semelhantes de problemas no EuroQol (exceto dor/desconforto) e escores semelhantes no World Health Organization Disability Assessment Schedule 2.0.

Study on the relationship between uncertainty in illness and recovery quality in patients with breast tumor / 中国实用护理杂志

Objective To investigate the relationship between uncertainty in illness and recovery quality. Methods A cross sectional study was conducted from June to December 2015. The Chinese version Mishel Uncertainty in Illness Scale was used to assess uncertainty in illness of 168 patients with unconfirmed breast tumor undergoing general anesthesia. The following datarecovery time, time stay in postanesthesiacar unit, modified Observer′s Assessment of Alertness/Sedation Scale score etc were recorded. Results The breast tumor patients had a medium degree of illness uncertainty (81.11 ± 12.57) points. Educational background, marital status, family medical history, the severity of disease affect scores of illness uncertainty (P<0.05 or 0.01). Uncertainty in illnesswas negative correlated with recovery quality (P<0.05 or 0.01). Conclusions Uncertainty in illness of patients isrelated to recovery quality. Nursesshould instruct breast tumor patients to manage symptoms to decrease uncertainty in illness.

Comparison of Effects of Oxycodone Hydrochloride and Sufentanil on Anesthesia Recovery in Neurosurgical Operation / 医药导报

Objective To observe the recovery efficiency of sufentanil and oxycodone hydrochloride in neurosurgical operation.Methods Total of 120 patients scheduled for microvascular decompression under general anesthesia were randomly divided into 4 groups to receive 0.03 mg·kg-1 oxycodone (group H1), 0.05 mg·kg-1 oxycodone (group H2), 0.08 mg·kg-1 oxycodone (group H3), and 0.08 μg·kg-1 sufentanil (group S).Each patient accepted 4 ng·mL-1 of remifentanil and 5-6 mg·kg-1·h-1 of propofol after induction to maintain bispectral index (BIS) value at 40-60.On starting to suture dura mater, oxycodone or sufentanil was given in various doses through intravenous route.The BIS value, the amount consumption of propofol, anesthesia and operation duration, and the drug delivery time of each group were recorded.The time of spontaneous breath recovery, awaking and extubation, verbal rating score (VRS) and sedation score (SS) at 10 min, 20 min, 30 min after operation as well as side-effects were also recorded.Results The VRS scores had no statistic difference among the groups at 10 min after operation, while the average scores of H1 were higher than those of H2 and H3 at 20, 30 min after operation.No statistic difference of the SS scores was showed among 4 groups at 10 min after operation, but it was lower in group H1 than those in group H3, and lower in group S than those in H2 at 20 min after operation;group H3 had a significantly higher SS scores than H1, H2 and S at 30 min after operation.Conclusion Oycodone hydrochloride 0.05 mg·kg-1 or sufentanil 0.08 μg·kg-1 can both provide satisfactory recovery quality in neurosurgical operation.

Quality of recovery after anaesthesia measured with QoR-40: a prospective observational study / Qualidade da recuperação pós-anestesia medida com QoR-40: um estudo observacional prospectivo

Abstract Background: QoR-40, a 40-item questionnaire on quality of recovery from anaesthesia, has been shown to measure health status after surgery. Our aim was to evaluate the incidence of poor quality of recovery in our Post Anaesthesia Care Unit and to compare their QoR-40 scores before surgery and 3 months later. Methods: A prospective observational study was conducted in adult patients consecutively admitted from 18 June to 12 July 2012. The follow-up period was 3 months. We exclude patients submitted to cardiac surgery, neurosurgery, obstetric surgery and with a mini-mental state examination test score lower than 25. The primary endpoint was quality of recovery measured with the validated Portuguese for Portugal version of the QoR-40 before surgery (T0), 24 h after surgery (T1) and 3 months after (T2). Results: A total of 114 patients completed the study. Mean QoR-40 score was 169 and patients with poor quality of recovery were identified if their QoR-40 score was lesser than 142. This occurred in 26 patients (24%). Global median scores for patients with poor quality of recovery were lower at T0 (121 vs. 184, p < 0.001), at T1 (120 vs. 177, p < 0.001) and at T2 (119 vs. 189, p < 0.001). Conclusion: Patients with poor quality of recovery had lower quality of life. This fact may allow earlier and more effective interventions, in order to improve quality of life after surgery. Beside its utility after surgery, QoR-40 may be important prior to surgery to identify patients who will develop a poor quality of recovery.

Resumo Justificativa: QoR-40, um questionário com 40 itens sobre a qualidade de recuperação da anestesia, mostrou medir o estado de saúde após a cirurgia. O nosso objetivo foi avaliar a incidência de má qualidade da recuperação em nossa Sala de Recuperação Pós-Anestesia e comparar os escores do QoR-40 antes e três meses depois da cirurgia. Métodos: Estudo observacional prospectivo, feito com pacientes adultos admitidos consecutivamente de 18 de junho a 12 de julho de 2012. O período de acompanhamento foi de três meses. Excluímos os pacientes submetidos a cirurgia cardíaca, neurocirurgia, cirurgia obstétrica e aqueles com escore inferior a 25 no miniexame do estado mental. O desfecho primário foi a qualidade da recuperação medida com a versão do QoR-40, validada para a versão do português de Portugal, antes da cirurgia (T0), 24 horas após a cirurgia (T1) e três meses após a cirurgia (T2). Resultados: No total, 114 pacientes completaram o estudo. A média dos escores no QoR-40 foi de 169 e os pacientes com má qualidade de recuperação foram identificados se os seus escores no QoR-40 fossem menores do que 142. Isso ocorreu em 26 pacientes (24%). As médias dos escores globais dos pacientes com má qualidade de recuperação foram menores em T0 (121 vs. 184, p < 0,001), T1 (120 vs. 177, p < 0,001) e T2 (119 vs. 189, p < 0,001). Conclusão: Os pacientes com má qualidade de recuperação apresentaram uma pior qualidade de vida. Esse fato pode permitir intervenções precoces e mais eficazes para melhorar a qualidade de vida após a cirurgia. Além de sua utilidade após a cirurgia, o QoR-40 pode ser importante antes da cirurgia para identificar os pacientes que desenvolverão uma má qualidade de recuperação.

Effects of general anesthesia combined with thoracic paravertebral block on postoperative recovery after pulmonary lobectomy / 临床外科杂志

Objective To evaluate Effects of general anesthesia combined with thoracic paraver-tebral block(TPVB)on postoperative recovery after thoracoscopic pulmonary lobectomy. Methods Eighty patients were randomized into the general anesthesia group( G group)and general anesthesia combined TPVB group(GT group). Under the guidance of ultrasound,patients in the GT group received 20ml of 0. 5% ropivacaine for TPVB,and sevoflurane and propofol for combined anesthesia. Patients in the G group received sevoflurane,propofol and remifentanil for combined anesthesia. Extubation time,postoperative vis-ual analogue scale(VAS),quality of recovery(QoR)score,and adverse reaction were all recorded. Results Patients in the GT group had less extubation time and earlier ambulation time compared to the G group. Postoperatively,at the 1st,24th and 48th hour,patients in the G group had significantly higher VAS values both at rest and on movement than GT group(P < 0. 05). The opioid consumptions in GT group were lower than the G group(P < 0. 05). The QoR values of GT group at 24th and 48th hour[(152 ± 21)min and (175 ± 17)min]were significantly higher than the G group[(134 ± 25)min and(162 ± 20)min]respec-tively. There were significant differences in hospitalization expenses,the hospitalization stay and the inci-dence of complications between the two groups. Conclusion The ultrasound-guided paravertebral block can improve the quality of recovery in patients undergoing thoracoscopic pulmonary lobectomy.

Influential Factors on Quality of Recovery of Patients Undergone Cardiac Surgery / 재활간호학회지

PURPOSE: The purpose of this study was to identify the quality of recovery and influential factors on the quality of recovery after cardiac surgery. METHODS: 198 patients undergone cardiac surgery were asked to fill in a self-reported questionnaire about the quality of recovery, anxiety, depression including social support at discharge. The collected data were analyzed with mean, standard deviation, correlation and stepwised multiple regression. RESULTS: The mean scores of quality of recovery at discharge after cardiac surgery was 2.04 on a 3 point scale. Influential factors on the quality of recovery after cardiac surgery were depression(p=.001) and anxiety(p=.027), which disclosed 44.2% of explanation. Depression was the most influential factor. CONCLUSION: The influential factors on the quality of recovery at discharge after cardiac surgery were depression and anxiety. More studies will be required to reduce depression and anxiety in patients undergone cardiac surgery.

Prevalencia de dolor agudo posoperatorio y calidad de la recuperación en el Hospital Universitario San Vicente de Paúl, Medellín, Colombia, 2007 / Prevalence of acute postoperative pain and quality of recovery at a university-affiliated hospital in Medellín, Colombia, 2007

Objetivo: determinar la prevalencia de dolor agudo posoperatorio moderado o severo y la calidad de la recuperación en pacientes atendidos en un hospital universitario. Diseño: estudio prospectivo, observacional, de corte transversal, en el Hospital Universitario San Vicente de Paúl (HUSVP), Medellín, Colombia. Muestra: 112 pacientes hospitalizados, mayores de 18 años, en posoperatorio de cirugía ortopédica, torácica o abdominal. Métodos y resultados: se evaluaron el dolor posoperatorio dinámico y en reposo mediante la Escala Numérica Verbal (ENV) y la Calidad de la Recuperación por medio de una encuesta para determinar el bienestar y la funcionalidad física y mental de los pacientes. También se tuvieron en cuenta los efectos adversos asociados a la analgesia. La tasa de prevalencia del dolor moderado en reposo fue de 31,3% y la del dolor severo, 22,3%. Para el dolor dinámico moderado y severo, las tasas de prevalencia fueron de 27,6% y 48,2%, respectivamente. La calidad de la recuperación fue buena en el 80,4% de los pacientes. Se halló relación entre el dolor severo y la peor calidad de la recuperación. Los efectos adversos reportados fueron somnolencia (44,6%), náuseas (25%), epigastralgia (17%), retención urinaria (17%) y vómito (13,4%). Conclusiones: la tasa de prevalencia del dolor posoperatorio severo en el grupo de pacientes estudiado fue elevada y se asoció con resultados desfavorables en la calidad de la recuperación, lo cual motiva a poner en práctica estrategias que optimicen su control.

Objective: To determine the prevalence of acute moderate or severe postoperative pain and the quality of recovery at a university-affiliated hospital. Design: Prospective, observational, cross-sectional study at Hospital Universitario San Vicente de Paúl in Medellín, Colombia. Patients: 112 hospitalized patients, older than 18 years, in the postoperative period of orthopedic, thoracic or abdominal surgery. Methods and results: The static and dynamic postoperative pains were evaluated by means of a Verbal Numeric Rate Pain scale. The Quality of Recovery was measured with an instrument to determine the well-being and mental and physical functionality of the patients during the postoperative period. The adverse effects associated with analgesia were also taken into account. The prevalence rates of moderate and severe static postoperative pain were, respectively, 31.3% and 22.3%. For moderate and severe dynamic postoperative pain, the prevalence rates were 27.6% and 48.2%, respectively. The Quality of Recovery was good in 80.4% of the patients. An increase in the intensity of postoperative pain was correlated with a decrease in the quality of recovery. Adverse effects of analgesia were as follows: somnolence (44.6%), nausea (25%) epigastralgia (17%), urinary retention (17%) and vomit (13.4%). Conclusions: The prevalence rate of severe postoperative pain was high in this group of patients and it correlated with a decrease in the quality of recovery. Strategies to improve control of postoperative pain should be implemented in our milieu.

Assessment for the Quality of Recovery from General Anesthesia in Patients with Gynecologic Surgery / 대한마취과학회지

BACKGROUND: Quality of recovery, assessed by patients, is related to patients' satisfaction, and even to quality of life. Of numerous patient-based measures to evaluate the quality of recovery, a '40-item-quality of recovery (QoR-40)' has proved to be valid and reliable. Using this questionnaire, we evaluated the quality of recovery in the gynecological patients and tried to identify factors affecting the quality of recovery. METHODS: Patients undergoing gynecological surgery were asked to fill a questionnaire 8 to 9 p.m the day after the completion of anesthesia. Questionnaires were prepared after translation to Korean from 40-item-quality of recovery. From the anesthetic and recovery room records we collected data about patient's age, surgery types, anesthetic and surgical duration, recovery room stay, main anesthetic agents, and recovery room complications. RESULTS: A total of 383 patients completed the questionnaires. Patients aged under 40 got significantly lower QoR-40 scores than those aged over 40, especially in the dimension of pain (P < 0.05). Patients who had undergone laparoscopic surgery got higher scores than those had undergone non-laparoscopic surgery (P < 0.05). Patients who answered the questionnaires in more than 30 hours after the completion of anesthesia showed lower total scores than those who did in less than 30 hours, especially in the dimensions of emotional state and pain (P < 0.05). CONCLUSIONS: In gynecological patients, laparoscopic surgery improved quality of recovery. Quality of recovery was affected by age and survey time. Postoperative pain contributed to the decrease of the quality of recovery.