Björn Stessel1,2,3, Maarten Hendrickx1,4, Caroline Pelckmans1, Gerrit De Wachter5, Bart Appeltans6, Geert Braeken1, Jeroen Herbots1, Elbert Joosten2,7, Marc Van de Velde4, Wolfgang F F A Buhre2,8. 1. Department of Anesthesiology and Pain Medicine, Jessa Hospital, Hasselt, Belgium. 2. Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Maastricht, The Netherlands. 3. UHasselt, Faculty of Medicine and Life Sciences, LCRC, Agoralaan, Diepenbeek, Belgium. 4. Department of Anaesthesiology and Pain Medicine, University Hospital, Leuven, Belgium. 5. Department of Orthopedic Surgery, Jessa Hospital, Hasselt, Belgium. 6. Department of Abdominal Surgery, Jessa Hospital, Hasselt, Belgium. 7. Department of Clinical Epidemiology and Medical Technology Assessment, Maastricht University Medical Center+, Maastricht, The Netherlands. 8. School for Mental Health and Neuroscience (MHeNS), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
Abstract
BACKGROUND/ OBJECTIVES: This study aimed to study one-month recovery profile and to identify predictors of Quality of Recovery (QOR) after painful day surgery and investigate the influence of pain therapy on QOR. METHODS/ DESIGN: This is a secondary analysis of a single-centre, randomised controlled trial of 200 patients undergoing ambulatory haemorrhoid surgery, arthroscopic shoulder or knee surgery, or inguinal hernia repair between January 2016 and March 2017. Primary endpoints were one-month recovery profile and prevalence of poor/good QOR measured by the Functional Recovery Index (FRI), the Global Surgical Recovery index and the EuroQol questionnaire at postoperative day (POD) 1 to 4, 7, 14 and 28. Multiple logistic regression analysis was performed to determine predictors of QOR at POD 7, 14, and 28. Differences in QOR between pain treatment groups were analysed using the Mann-Whitney U test. RESULTS: Four weeks after haemorrhoid surgery, inguinal hernia repair, arthroscopic knee and arthroscopic shoulder surgery, good QOR was present in 71%, 76%, 57% and 24% respectively. Poor QOR was present in 5%, 0%, 7% and 29%, respectively. At POD 7 and POD 28, predictors for poor/intermediate QOR were type of surgery and a high postoperative pain level at POD 4. Male gender was another predictor at POD 7. Female gender and having a paid job were also predictors at POD 28. Type of surgery and long term fear of surgery were predictors at POD 14. No significant differences in total FRI scores were found between the two different pain treatment groups. CONCLUSIONS: The present study shows a procedure-specific variation in recovery profile in the 4-week period after painful day surgery. The best predictors for short-term (POD 7) and long-term (POD 28) poor/intermediate QOR were a high postoperative pain level at POD 4 and type of surgery. Different pain treatment regimens did not result in differences in recovery profile. TRIAL REGISTRATION: European Union Clinical Trials Register 2015-003987-35.
RCT Entities:
BACKGROUND/ OBJECTIVES: This study aimed to study one-month recovery profile and to identify predictors of Quality of Recovery (QOR) after painful day surgery and investigate the influence of pain therapy on QOR. METHODS/ DESIGN: This is a secondary analysis of a single-centre, randomised controlled trial of 200 patients undergoing ambulatory haemorrhoid surgery, arthroscopic shoulder or knee surgery, or inguinal hernia repair between January 2016 and March 2017. Primary endpoints were one-month recovery profile and prevalence of poor/good QOR measured by the Functional Recovery Index (FRI), the Global Surgical Recovery index and the EuroQol questionnaire at postoperative day (POD) 1 to 4, 7, 14 and 28. Multiple logistic regression analysis was performed to determine predictors of QOR at POD 7, 14, and 28. Differences in QOR between pain treatment groups were analysed using the Mann-Whitney U test. RESULTS: Four weeks after haemorrhoid surgery, inguinal hernia repair, arthroscopic knee and arthroscopic shoulder surgery, good QOR was present in 71%, 76%, 57% and 24% respectively. Poor QOR was present in 5%, 0%, 7% and 29%, respectively. At POD 7 and POD 28, predictors for poor/intermediate QOR were type of surgery and a high postoperative pain level at POD 4. Male gender was another predictor at POD 7. Female gender and having a paid job were also predictors at POD 28. Type of surgery and long term fear of surgery were predictors at POD 14. No significant differences in total FRI scores were found between the two different pain treatment groups. CONCLUSIONS: The present study shows a procedure-specific variation in recovery profile in the 4-week period after painful day surgery. The best predictors for short-term (POD 7) and long-term (POD 28) poor/intermediate QOR were a high postoperative pain level at POD 4 and type of surgery. Different pain treatment regimens did not result in differences in recovery profile. TRIAL REGISTRATION: European Union Clinical Trials Register 2015-003987-35.
Authors: M Brattwall; M Warrén Stomberg; N Rawal; M Segerdahl; J Jakobsson; E Houltz Journal: Acta Anaesthesiol Scand Date: 2010-10-07 Impact factor: 2.105
Authors: Björn Stessel; Michiel Boon; Caroline Pelckmans; Elbert A Joosten; Jean-Paul Ory; Werner Wyckmans; Stefan Evers; Sander M J van Kuijk; Marc Van de Velde; Wolfgang F F A Buhre Journal: Eur J Anaesthesiol Date: 2019-05 Impact factor: 4.330
Authors: Gildasio S De Oliveira; Paul Fitzgerald; Lauren F Streicher; R-Jay Marcus; Robert J McCarthy Journal: Anesth Analg Date: 2012-05-14 Impact factor: 5.108
Authors: Björn Stessel; Michiel Boon; Elbert A Joosten; Jean-Paul Ory; Stefan Evers; Sander M J van Kuijk; Jasperina Dubois; Daisy Hoofwijk; Luc Jamaer; Wolfgang F F A Buhre Journal: Trials Date: 2016-09-26 Impact factor: 2.279
Authors: Björn Stessel; Audrey A A Fiddelers; Marco A Marcus; Sander M J van Kuijk; Elbert A Joosten; Madelon L Peters; Wolfgang F F A Buhre; Hans-Fritz Gramke Journal: Clin J Pain Date: 2017-05 Impact factor: 3.442