Background and Goal of Study

Quality of recovery is an important end-point for
evaluating anaesthesia and surgery. To capture the
long-term impact of anaesthesia and surgery,
measures need to include not only physiological
measures of recovery but also patient reported
outcomes and satisfaction.
The Postoperative Quality of Recovery Scale (PQRS)
evaluates recovery in multiple domains (physiological,
nociceptive, emotive, cognitive and activities of daily
living (ADLs). We aimed to determine overall
satisfaction in a cohort of laparoscopic cholecystectomy
patients.

Materials and methods

Patients undergoing elective cholecystectomy during a
3 month period were included. The PQRS tool was
utilised. Baseline testing in all domains was performed
preoperatively. Postoperatively, assessments were
performed at 15 and 45 minutes after the end of
anaesthesia. Late recovery assessments were carried
out at day 1 and day 3 postoperatively.
Recovery was defined as return to baseline values or
better in each assessment.

Results and discussion

10 female and 4 male patients were enrolled. Mean
age was 42 years. Physiological parameters (heart
rate, respiratory rate etc) displayed 100% recovery at
45 minutes. Patients´ reported increased pain at day 1
and 3 with 30% and 25% recovery respectively. This
was compared to preoperatively and 35% recovery at
45 minutes postoperatively. Reduced nociceptive
recovery correlated with reduced emotional recovery
and reduced ability to attend to ADLs (30% recovery at
1 day). Patients displayed 100% cognitive recovery by
day 3. All patients reported satisfaction or complete
satisfaction with their anaesthetic and surgery despite
having not fully recovered in the nociceptive, emotional
and ADLs domains. In common with similar studies
satisfaction is poor at discriminating quality of care and
recovery.

Conclusion(s)
Patients consistently rate anaesthetic care highly,
making it difficult to discriminate quality of recovery.
Using the PQRS tool revealed that patients
experienced increased pain on day 1 and 3
postoperatively that negatively impacted upon the
emotional recovery and return to ADLs of patients´
compared to preoperatively.

Evaluation of postoperative recovery and satisfaction with anaesthesia and surgery using the Postoperative Quality of Recovery Scale (PQRS) in patients undergoing laparoscopic cholecystectomy