Post-operative Quality of Recovery Scale: the impact of assessment method on cognitive recovery

Abstract Background Our objective was to evaluate the impact of multimodal analgesia based enhanced recovery protocol on quality of recovery after laparoscopic gynecological surgery. Methods One hundred forty female patients scheduled for laparoscopic gynecological surgery were enrolled in this prospective, randomized controlled trial. Participants were randomized to receive either multimodal analgesia (Study group) or conventional opioid-based analgesia (Control group). The multimodal analgesic protocol consists of pre-operative acetaminophen and gabapentin, intra-operative flurbiprofen and ropivacaine, and post-operative acetaminophen and celecoxib. Both groups received an on-demand mode patient-controlled analgesia pump containing morphine for rescue analgesia. The primary outcome was Quality of Recovery-40 score at postoperative day (POD) 2. Secondary outcomes included numeric pain scores (NRS), opioid consumption, clinical recovery, C-reactive protein, and adverse events. Results One hundred thirty-eight patients completed the study. The global QoR-40 scores at POD 2 were not significantly different between groups, although scores in the pain dimension were higher in Study group (32.1 ± 3.0 vs. 31.0 ± 3.2, P = 0.033). In the Study group, NRS pain scores, morphine consumption, and rescue analgesics in PACU (5.8% vs. 27.5%; P = 0.0006) were lower, time to ambulation [5.0 (3.3–7.0) h vs. 6.5 (5.0–14.8) h; P = 0.003] and time to bowel function recovery [14.5 (9.5–19.5) h vs.17 (13–23.5) h; P = 0.008] were shorter, C-reactive protein values at POD 2 was lower [4(3–6) ng/ml vs. 5 (3–10.5) ng/ml; P = 0.022] and patient satisfaction was higher (9.8 ± 0.5 vs. 8.8 ± 1.2, P = 0.000). Conclusion For minimally invasive laparoscopic gynecological surgery, multimodal analgesia based enhanced recovery protocol offered better pain relief, lower opioid use, earlier ambulation, faster bowel function recovery and higher patient satisfaction, while no improvement in QoR-40 score was found. Trial registration ChiCTR1900026194; Date registered: Sep 26,2019.

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Influence of catastrophizing, anxiety, and depression on in-hospital opioid consumption, pain, and quality of recovery after adult spine surgery

Journal of Neurosurgery Spine ◽

10.3171/2017.5.spine1734 ◽

2018 ◽

Vol 28 (1) ◽

pp. 119-126 ◽

Cited By ~ 42

Author(s):

Lauren K. Dunn ◽

Marcel E. Durieux ◽

Lucas G. Fernández ◽

Siny Tsang ◽

Emily E. Smith-Straesser ◽

...

Keyword(s):

Spine Surgery ◽

Rating Scale ◽

Psychological Intervention ◽

Opioid Consumption ◽

Anxiety And Depression ◽

Opioid Use ◽

Quality Of Recovery ◽

Pain Scores ◽

The Impact

OBJECTIVEPerception of perioperative pain is influenced by various psychological factors. The aim of this study was to determine the impact of catastrophizing, anxiety, and depression on in-hospital opioid consumption, pain scores, and quality of recovery in adults who underwent spine surgery.METHODSPatients undergoing spine surgery were enrolled in this study, and the preoperatively completed questionnaires included the verbal rating scale (VRS), Pain Catastrophizing Scale (PCS), Hospital Anxiety and Depression Scale (HADS), and Oswestry Disability Index (ODI). Quality of recovery was assessed using the 40-item Quality of Recovery questionnaire (QoR40). Opioid consumption and pain scores according to the VRS were recorded daily until discharge.RESULTSOne hundred thirty-nine patients were recruited for the study, and 101 completed the QoR40 assessment postoperatively. Patients with higher catastrophizing scores were more likely to have higher maximum pain scores postoperatively (estimate: 0.03, SE: 0.01, p = 0.02), without increased opioid use (estimate: 0.44, SE: 0.27, p = 0.11). Preoperative anxiety (estimate: 1.18, SE: 0.65, p = 0.07) and depression scores (estimate: 1.06, SE: 0.71, p = 0.14) did not correlate with increased postoperative opioid use; however, patients with higher preoperative depression scores had lower quality of recovery after surgery (estimate: −1.9, SE: 0.56, p < 0.001).CONCLUSIONSCatastrophizing, anxiety, and depression play important roles in modulating postoperative pain. Preoperative evaluation of these factors, utilizing a validated tool, helps to identify patients at risk. This might allow for earlier psychological intervention that could reduce pain severity and improve the quality of recovery.

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Validation of the Chinese Version of the Quality of Recovery-15 Score and Its Comparison with the Post-Operative Quality Recovery Scale

The Patient: Patient-Centered Outcomes Research ◽

10.1007/s40271-015-0148-6 ◽

2015 ◽

Vol 9 (3) ◽

pp. 251-259 ◽

Cited By ~ 19

Author(s):

Xue-Shan Bu ◽

Jing Zhang ◽

Yun-Xia Zuo

Keyword(s):

Chinese Version ◽

Quality Of Recovery ◽

Operative Quality

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The assessment of early cognitive recovery after surgery and anaesthesia using the Postoperative Quality of Recovery Scale

European Journal of Anaesthesiology ◽

10.1097/00003643-201306001-00030 ◽

2013 ◽

Vol 30 ◽

pp. 10-11 ◽

Cited By ~ 1

Author(s):

C. Royse ◽

S. Newman ◽

D. Wilkinson

Keyword(s):

Cognitive Recovery ◽

Quality Of Recovery ◽

Postoperative Quality

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Don’t write, just mark: the validity of assessing student ability via their computerized peer-marking of an essay rather than their creation of an essay

Research in Learning Technology ◽

10.3402/rlt.v12i3.11258 ◽

2004 ◽

Vol 12 (3) ◽

Cited By ~ 1

Author(s):

Phil Davies

Keyword(s):

Multiple Choice ◽

Assessment Method ◽

Subject Area ◽

Higher Order ◽

The Subject ◽

Student Ability ◽

Method Of Assessment ◽

The Impact

This paper reports on a case study that evaluates the validity of assessing students via a computerized peer-marking process, rather than on their production of an essay in a particular subject area. The study assesses the higher-order skills shown by a student in marking and providing consistent feedback on an essay. In order to evaluate the suitability of this method of assessment in judging a student’s ability, their results in performing this peer-marking process are correlated against their results in a number of computerized multiple-choice exercises and also the production of an essay in a cognate area of the subject being undertaken. The results overall show a correlation of the expected results in all three areas of assessment being undertaken, rated by the final grades of the students undertaking the assessment. The results produced by quantifying the quality of the marking and commenting of the students is found to map well to the overall expectations of the results produced for the cohort of students. It is also shown that the higher performing students achieve a greater improvement in their overall marks by performing the marking process than those students of a lower quality. This appears to support previous claims that awarding a ‘mark for marking’ rewards the demonstration of higher order skills of assessment. Finally, note is made of the impact that such an assessment method can have upon eradicating the possibility of plagiarism.DOI: 10.1080/0968776042000259573

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Assessing the quality of research: preparing for REF2021

The Biochemist ◽

10.1042/bio03902048 ◽

2017 ◽

Vol 39 (2) ◽

pp. 48-49

Author(s):

Gabriele Butkute

Keyword(s):

Assessment Method ◽

Research Excellence Framework ◽

Research Excellence ◽

The Uk ◽

The Impact ◽

Quality Of Research

In an age where huge amounts of data is collected on everything we do – from our Google searches to our GPS coordinates – we like to be able to count, measure and assess things. This includes measuring the impact and quality of research in the UK, through an assessment method known as the Research Excellence Framework (REF).

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Influence of Reversal with Sugammadex or Neostigmine on Post-Operative Quality of Recovery Following a Single Bolus Dose of Rocuronium: A Prospective, Randomised, Double-Blinded, Controlled Study

10.20944/preprints201811.0005.v1 ◽

2018 ◽

Author(s):

Sun-Joon Bai ◽

Ki-Young Lee ◽

Sung Soo Kim ◽

Jung Hwa Hong ◽

Hoon Jae Nam ◽

...

Keyword(s):

General Anaesthesia ◽

Bolus Dose ◽

Controlled Study ◽

Single Bolus ◽

Quality Of Recovery ◽

Single Bolus Dose ◽

Pars Plana ◽

Double Blinded ◽

Operative Quality

There is a lack of data comparing sugammadex with anticholinesterase for the quality of anaesthesia recovery, especially following a single bolus dose of rocuronium. Thus, we evaluated the influence of reversal with sugammadex or neostigmine on post-operative quality of recovery by using the Post-operative Quality Recovery Scale (PQRS). A total of 86 patients undergoing trans-pars plana vitrectomy (TPPV) under general anaesthesia were intubated following a single bolus dose of rocuronium (0.6 mg/kg). At the end of surgery, patients were received either neostigmine or sugammadex. The quality of recovery was assessed using the PQRS at 15 minutes and 40 minutes after surgery, and on post-operative day 1. The recovery rate in the physiological domain was higher in the sugammadex group at 15 minutes after surgery (P = 0.02). Though there were no significant differences in the overall cognitive recovery domain, patients in the sugammadex group could recall more numbers in reverse order. However, there were no significant differences between the groups in the other domains of the PQRS. The use of sugammadex may increase the quality of the post-operative physiological recovery at early post-operative periods compared with neostigmine use following a single bolus dose of rocuronium in patients undergoing TPPV with general anaesthesia.

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