Colin F Royse1, Frances Chung, Stanton Newman, Jan Stygall, David J Wilkinson. 1. Anaesthesia and Pain Management Unit, Department of Pharmacology, University of Melbourne and Department of Anaesthesia and Pain Management, The Royal Melbourne Hospital, Melbourne, Victoria, Australia. colin.royse@unimelb.edu.au
Abstract
CONTEXT: Previous research has shown that most patients are satisfied with their anaesthetic care. For those who are not the causes may be multifactorial including dissatisfaction with surgical outcomes. OBJECTIVES: We aimed to identify whether quality of recovery after anaesthesia and surgery measured in multiple domains affects patient satisfaction. DESIGN: Sub-group analysis of previously published observational cohort study of quality of recovery after surgery (using the Postoperative Quality of Recovery Scale) was used to identify predictors of incomplete satisfaction 3 days after surgery. SETTING: Multicentre perioperative surgery. PATIENTS: Patients ≥6 years old, undergoing a variety of operation types and all receiving general anaesthesia. OBSERVATIONS: Of 701 patients, 573 completed the satisfaction question on day 3. Satisfaction was rated by a single five-point rating question. Patients were divided into two groups: 477 (83%) were completely satisfied and 96 (17%) were not completely satisfied. Multivariable logistic regression analysis was performed on preoperative and patient characteristics and recovery in five domains as follows: physiological, nociceptive (pain and nausea), emotive (anxiety and depression), activities of daily living and cognition. Recovery was defined as return to baseline values or better for all questions within each domain. RESULTS: Incomplete satisfaction was predicted by persistent pain or nausea at day 3 [OR 8.2 (95% CI 2.5 to 27), P<0.01] and incomplete satisfaction at day 1 [OR 28 (95% CI 10 to 77), P<0.01]. Paradoxically, incomplete satisfaction was less likely to occur if pain or nausea was present 15 min after surgery [OR 0.34 (95% CI 0.11 to 0.99), P<0.05] or at day 1 [OR 0.30 (95% CI 0.10 to 0.91), P=0.03]. Incomplete recovery in the other domains did not influence satisfaction. CONCLUSION: Of the recovery domains measured using the Postoperative Quality of Recovery Scale, only nociception (pain or nausea) contributed to incomplete satisfaction.
CONTEXT: Previous research has shown that most patients are satisfied with their anaesthetic care. For those who are not the causes may be multifactorial including dissatisfaction with surgical outcomes. OBJECTIVES: We aimed to identify whether quality of recovery after anaesthesia and surgery measured in multiple domains affects patient satisfaction. DESIGN: Sub-group analysis of previously published observational cohort study of quality of recovery after surgery (using the Postoperative Quality of Recovery Scale) was used to identify predictors of incomplete satisfaction 3 days after surgery. SETTING: Multicentre perioperative surgery. PATIENTS: Patients ≥6 years old, undergoing a variety of operation types and all receiving general anaesthesia. OBSERVATIONS: Of 701 patients, 573 completed the satisfaction question on day 3. Satisfaction was rated by a single five-point rating question. Patients were divided into two groups: 477 (83%) were completely satisfied and 96 (17%) were not completely satisfied. Multivariable logistic regression analysis was performed on preoperative and patient characteristics and recovery in five domains as follows: physiological, nociceptive (pain and nausea), emotive (anxiety and depression), activities of daily living and cognition. Recovery was defined as return to baseline values or better for all questions within each domain. RESULTS: Incomplete satisfaction was predicted by persistent pain or nausea at day 3 [OR 8.2 (95% CI 2.5 to 27), P<0.01] and incomplete satisfaction at day 1 [OR 28 (95% CI 10 to 77), P<0.01]. Paradoxically, incomplete satisfaction was less likely to occur if pain or nausea was present 15 min after surgery [OR 0.34 (95% CI 0.11 to 0.99), P<0.05] or at day 1 [OR 0.30 (95% CI 0.10 to 0.91), P=0.03]. Incomplete recovery in the other domains did not influence satisfaction. CONCLUSION: Of the recovery domains measured using the Postoperative Quality of Recovery Scale, only nociception (pain or nausea) contributed to incomplete satisfaction.
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