Patient satisfaction with anesthesia and surgery: application of the Postoperative Quality Recovery Scale
Oliveira, M.; Amaral, T.; Mendes, L.; Abelha, F.; Santos, A.

Introduction and goal of study
Anesthesia is still a major concern for patients but previous research has shown that most patients are satisfied with their anesthetic care. We aimed to evaluate if the quality of recovery has influence on patient’s satisfaction after anesthesia.
Materials and Methods 
After approval by the institutional ethics committee, an observational, prospective study was performed in patients scheduled for elective surgery. Patients included were older than 18 years, undergoing plastic, gynecologic, urologic and general surgery, under general anesthesia, admitted to the Post Anesthetic Care Unit (PACU). Exclusion criteria were: inability to give informed consent and regional anesthesia. Postoperative Quality of Recovery Scale (PQRS) was used to identify patients with complete satisfaction (PCS) and patients with incomplete satisfaction 3 days after surgery. PQRS and Quality of Recovery 15 score (QoR-15) were used to evaluate the quality of recovery after surgery. PQRS was used at baseline (up to 14 days before surgery) and after surgery at minute 15 (T15), 40 (T40) and days 1 (D1) and 3 (D3) evaluating recovery in five domains: physiological (PD), nociceptive (ND), emotive (ED), activities of daily living (AD) and cognition (CD). Recovery was defined as return to baseline values for all questions in each domain. Satisfaction was assessed by a five-point rating question. The Mann-Whitney test, Chi-square or Fisher’s exact test were used for comparisons.
Results 
Of 206 patients, 175 completed the satisfaction question on D3. PCS were 86.3%. Incomplete satisfaction was more frequent in patients with incomplete recovery at different timings and in different domains: at 15 minutes in ED (95% vs. 75%, p=0.025), at 40 minutes in PD (25% vs. 5%, p=0.035), at D1 in CD (100% vs. 75%, p=0.014) and AD (77% vs. 54%, p=0.034) and at D3 in AD (48% vs. 26%, p=0.036). Total median QoR-15 score at D1 was higher in PCS (126 vs. 117, p=0.041). Patients with incomplete satisfaction stayed for longer in the hospital (7 vs. 4 days, p=0.003) and in the PACU (p=0.002).
Conclusion(s)
Patients with incomplete satisfaction had a poor quality of recovery 24 hours after surgery. Beyond this time frame recovery in cognition and activities of daily living played an important role in patient’s satisfaction.

Patient satisfaction with anesthesia and surgery: application of the postoperative quality recovery scale