Postoperative Recovery Quality after General Anesthesia in Patients Undergoing Emergency Surgery
DOI:
https://doi.org/10.3889/oamjms.2021.6549Keywords:
General anesthesia, Postoperative, Quality of recovery-40, Quality of recoveryAbstract
BACKGROUND: The quality of post-operative patient recovery is part of the indicators of the quality of anesthesia services. However, side effects were still found in post-operative patients, which resulted in the speed and quality of recovery (QoR) and an increase in the length of stay for patients in the hospital.
AIM: This study aims to describe the quality of a patient’s recovery after general anesthesia for patients undergoing surgery in the emergency room.
MATERIALS AND METHODS: This research is a descriptive study with a cross-sectional design conducted from February to July 2020. Patients numbered 52 people who are patients aged 18–59 years who are willing to fill out a questionnaire QoR-40 on the day after surgery. All data were analyzed using the statistical program SPSS. The median of the QoR-40 score will be used as a cutoff point between good and poor recovery quality.
RESULTS: Fifty-two patients responded to the study with a median age of 44 years. The median QoR-40 score was 188, with most of the good category’s recovery quality (55.8%). The middle-aged group showed better QoR (68.2 vs. 31.8%), as well as the female compared to male (65 vs. 35%). Patients who underwent neurosurgery showed poor recovery 61.9 vs. 38.1%).
CONCLUSION: More than half of the patients who underwent emergency surgery under general anesthesia in the emergency room of Sanglah Hospital have good recovery quality.Downloads
Metrics
Plum Analytics Artifact Widget Block
References
World Health Organization. Size and Distribution of the Global Volume of Surgery in 2012. Geneva: World Health Organization; 2012. Available from: http://www.who.int/bulletin/volumes/94/3/15-159293/en. [Last accessed on 2021 Apr 27].
Meara JG, Leather AJ, Hagander L, Alkire BC, Alonso N, Ameh EA, et al. Global Surgery 2030: Evidence and solutions for achieving health, welfare, and economic development. Int J Obstet Anesth. 2016;25:75-8. PMid:26597405
Parami P, Ryalino C. The incidence of post-operative cognitive dysfunction in elderly patients underwent elective surgery at Sanglah General Hospital. Bali J Anesthesiol. 2020;4(Suppl 2):61-3. https://doi.org/10.4103/bjoa.bjoa_109_20 DOI: https://doi.org/10.4103/BJOA.BJOA_109_20
Shirley E, Sanders J. Patient satisfaction: Implication and predictors of success. J Bone Jt Surg Am. 2013;95(10):e69. PMid:23677370 DOI: https://doi.org/10.2106/JBJS.L.01048
Kluivers K, Riphagen I, Vierhout M, Brölmann HA, de Vet HC. Systematic review on recovery specific quality-of-life instruments. Surgery. 2008;143(2):206-15. https://doi.org/10.1016/j.surg.2007.08.017 PMid:18242337 DOI: https://doi.org/10.1016/j.surg.2007.08.017
Barnet S, Alagar R, Grocott M, Giannaris S, et al. Post-operative recovery and its association with health-related quality of life among day surgery patients. BioMed Cent Nurs J. 2012;11:24. PMid:23148514 DOI: https://doi.org/10.1186/1472-6955-11-24
Aribawa IGN, Senapathi TG, Widnyana IM, Hartawan IG, Pradana AP, Ryalino C. Comparison between target-controlled infusion propofol and target-controlled inhalational anesthesia sevoflurane in mastectomy surgery in Indonesia. Bali J Anesthesiol. 2021;5:61-5. https://doi.org/10.4103/bjoa.bjoa_178_20 DOI: https://doi.org/10.4103/BJOA.BJOA_178_20
Gornall B, Myles P, Smith C, Burke J. Measurement of qualityof recovery using the QoR-40: A quantitative systematic review. Br J Anesth. 2013;111(2):161-9. PMid:23471753 DOI: https://doi.org/10.1093/bja/aet014
Guimaraes P, Costa M, Sousa G, Abelha F. Quality of recovery after anaesthesia measured with QoR-40: A prospective observational study. Braz J Anesth. 2016;66(4):369-75. https://doi.org/10.1016/j.bjane.2014.11.010 PMid:27343786 DOI: https://doi.org/10.1016/j.bjane.2014.11.010
Myles PS, Weitkamp B, Jones K, Melick J, Hensen S. Validity and reliability of a post-operative quality of recovery score: The QoR-40. Br J Anaesth. 2000;84(1):11-5. https://doi.org/10.1093/oxfordjournals.bja.a013366 PMid:10740540 DOI: https://doi.org/10.1093/oxfordjournals.bja.a013366
Buchanan FF, Myles PS, Cicuttini F. Effect of patient sex on general anaesthesia and recovery. Br J Anaesth. 2011;106(6):832-9. https://doi.org/10.1093/bja/aer094 PMid:21558068 DOI: https://doi.org/10.1093/bja/aer094
Koenig K. Comparing prescriptive and descriptive gender stereotypes about children, adults, and the elderly. Front Physiol. 2018;9:1086. https://doi.org/10.3389/fpsyg.2018.01086 PMid:29997558 DOI: https://doi.org/10.3389/fpsyg.2018.01086
Buchanan FF, Myles PS, Cicuttini F. Patient sex and its influence on general anaesthesia. Anaesth Intensive Care. 2009;37(2):207-18. https://doi.org/10.1177/0310057x0903700201 PMid:19400484 DOI: https://doi.org/10.1177/0310057X0903700201
Bajaj P, Raiger LK, Jain SD, Kumar S. Women emerge from general anesthesia faster than men. Middle East J Anesthesiol. 2007;19(1):173-83. PMid:17511191
Sveinsdottir H, Borgthorsdottir T, Asgeirsdottir MT, Albertsdottir K, Asmundsdottir LB. Recovery after same-day surgery in patients receiving general anesthesia: A cohort study using the quality of recovery-40 questionnaire. J Perianesthesia Nurs. 2016;31(6):475-84. https://doi.org/10.1016/j.jopan.2015.07.003 PMid:27931699 DOI: https://doi.org/10.1016/j.jopan.2015.07.003
Myles PS, Bs MB, Hunt JO, Nightingale CE, Fletcher H, Beh T, et al. Development and psychometric testing of a quality of recovery score after general anesthesia and surgery in adults. Anesth Analg. 1999;88(1):83-90. https://doi.org/10.1213/00000539-199901000-00016 PMid:9895071 DOI: https://doi.org/10.1213/00000539-199901000-00016
Berg K, Idvall E, Nilsson U, Arestedt KF, Unosson M. Psychometric evaluation of the post-discharge surgical recovery scale. J Eval Clin Pract. 2010;16(4):794-801. https://doi.org/10.1111/j.1365-2753.2009.01197.x PMid:20557414 DOI: https://doi.org/10.1111/j.1365-2753.2009.01197.x
Rahman AARA, Mahdy NE, Kamaly AM. Predictive factors affecting post-operative quality of recovery for patients undergoing surgery. IOSR J Nurs Heal Sci. 2017;6(3):50-60. DOI: https://doi.org/10.9790/1959-0603085060
Carolina A, Sousa G, Santos C, Abelha F. Quality of recovery after anesthesia: validation of the portuguese version of the quality of recovery 15 questionnaire. Acta Med Port. 2015;28(5):567-74. https://doi.org/10.20344/amp.6129 PMid:26667859 DOI: https://doi.org/10.20344/amp.6129
Mangoni A., Jackson SH. Age-related changes in pharmacokinetics and pharmacodynamics: Basic principles and practical applications. Br J Clin Pharmacol. 2004;57(1):6-14. https://doi.org/10.1046/j.1365-2125.2003.02007.x PMid:14678335 DOI: https://doi.org/10.1046/j.1365-2125.2003.02007.x
Orchs H, Greenblatt D, Divoll M, Abernethy D. Diazepam kinetics in relation to age and sex. Pharmacology. 1981;23(1):24-30. https://doi.org/10.1159/000137524 PMid:7312934 DOI: https://doi.org/10.1159/000137524
Hamzah H, Bratha IN, Sumartono C, Utariani A, Semedi BP, Avidar YP. Comparison of outcome between patients receiving general anesthesia combined with continuous epidural anesthesia and patients receiving general anesthesia combined with intermittent epidural anesthesia. Bali J Anesthesiol. 2020;4:118-21. https://doi.org/10.4103/bjoa.bjoa_18_20 DOI: https://doi.org/10.4103/BJOA.BJOA_18_20
Lanitis S, Mimigianni C, Raptis D, Sourtse G, Sgourakis G, Karaliotas C. The impact of educational status on the postoperative perception of pain. Korean J Pain. 2015;28(4):265-74. https://doi.org/10.3344/kjp.2015.28.4.265 PMid:26495081 DOI: https://doi.org/10.3344/kjp.2015.28.4.265
Oshodi TO. The impact of preoperative education on post-operative pain. Part 2. Br J Nurs. 2007;16(13):790-7. PMid:17851332 DOI: https://doi.org/10.12968/bjon.2007.16.13.24244
Stessel B, Fiddelers AA, Joosten EA, Hoofwijk DM, Gramke HF, Buhre WF. Prevalence and predictors of quality of recovery at home after day surgery. Medicine (Baltimore). 2015;94(39):e1553. https://doi.org/10.1097/md.0000000000001553 PMid:26426622 DOI: https://doi.org/10.1097/MD.0000000000001553
Onerup A, Angerås U, Bock D, Börjesson M, Fagevik Olsén M, et al. The preoperative level of physical activity is associated to the post-operative recovery after elective cholecystectomy a cohort study. Int J Surg. 2015;19:35-41. https://doi.org/10.1016/j.ijsu.2015.05.023 PMid:26003290 DOI: https://doi.org/10.1016/j.ijsu.2015.05.023
Nilsson H, Angerås U, Bock D, Börjesson M, Onerup A, Olsen MF, et al. Is preoperative physical activity related to post-surgery recovery? A cohort study of patients with breast cancer. BMJ Open. 2016;6(1):e007997. https://doi.org/10.1136/bmjopen-2015-007997 PMid:26769776 DOI: https://doi.org/10.1136/bmjopen-2015-007997
Moro ET, da Silva MA, Couri MG, da Silva Issa D, Barbieri JM. Quality of recovery from anesthesia in patients undergoing orthopedic surgery of the lower limbs. Braz J Anesthesiol. 2016;66(6):642-50. https://doi.org/10.1016/j.bjane.2015.05.001 PMid:27793240 DOI: https://doi.org/10.1016/j.bjane.2015.05.001
de Carli D, Meletti JF, Neto NE, Martinez G, Kim AL, de Camargo RP. General anesthesia technique and perception of quality of post-operative recovery in women undergoing cholecystectomy: A randomized, double-blinded clinical trial. PLoS One. 2020;15(2):e0228805. https://doi.org/10.1371/journal.pone.0228805 PMid:32107487 DOI: https://doi.org/10.1371/journal.pone.0228805
Jenkins K, Grady D, Wong J, Correa R, Armanious S, Chung F. Post-operative recovery: Day surgery patients’ preferences. Br J Anaesth. 2001;86(2):272-4. https://doi.org/10.1093/bja/86.2.272 PMid:11573673 DOI: https://doi.org/10.1093/bja/86.2.272
Strozyk S, Wernecke K, Sehouli J, David M. Factor influencing post-operative recovery and time off work of patients with benign indication for surgery-results of a prospective study. Geburtshilfe Frauenheilkd. 2020;80(7):723-32. https://doi.org/10.1055/a-1157-8996 PMid:32675834 DOI: https://doi.org/10.1055/a-1157-8996
Sandhu K, Dash H. Awareness during anaesthesia. Indian J Anaesth. 2009;53(2):148-57. PMid:20640115
Vacas S, Wiele V. designing a pain management protocol for craniotomy: A narrative review and consideration of promising practices. Surg Neurol Int. 2017;8:291. https://doi.org/10.4103/sni.sni_301_17 PMid:29285407 DOI: https://doi.org/10.4103/sni.sni_301_17
Leslie K, Troedel S, Irwin K, Pearce F, Ugoni A, Gillies R, et al. Quality of recovery from anesthesia in neurosurgical patients. Anesthesiology. 2003;99(5):1158-65. https://doi.org/10.1097/00000542-200311000-00024 PMid:14576554 DOI: https://doi.org/10.1097/00000542-200311000-00024
Farhni M, Schwarz E, Stadlmann S, Singer G, Hauser N, Hubik- Huch R. Breast abscesses: Diagnosis, treatment and outcome. Breast Care. 2012;7(1):32-8. https://doi.org/10.1159/000336547 PMid:22553470 DOI: https://doi.org/10.1159/000336547
Downloads
Published
How to Cite
License
Copyright (c) 2020 I Gusti Agung Gede Utara Hartawan, Made Violin Weda Yani, Tjokorda Gde Agung Senapathi, I Made Gede Widnyana, Christopher Ryalino, Cynthia Dewi Sinardja, Adinda Putra Pradhana (Author)

This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
http://creativecommons.org/licenses/by-nc/4.0