Aanesthetic Agents for Day Surgery - NIHR Health Technology ...

154
Appendix 6
TABLE 68 contd Summary of adult patient-based outcomes studies
Study Investigations Outcome Results Conclusions and Reviewers’ comments
and subjects measures grade of evidence
Luntz et al., (1) TIVA with Aldrete score Nausea was significantly Inhalation induction Abstract only
2000, 195
propofol (time of more severe in group 3 of anaesthesia with
Germany recovery); mean at 30 and 60 min; for both sevoflurane (group 3) Unclear how patient
(2) Propofol for arterial blood group 1 and 2 –120 min was associated with a satisfaction was measured
Comparative induction and pressure; vs group 1 lower incidence of or what questions were
study; abstract sevoflurane for incidence of hypotension; following asked at the 24 h interview.
only maintenance postoperative No difference with regard anaesthesia induction Unable to draw any
shivering, pain to shivering 24 h after in the elderly, some conclusions without full
(3) Sevoflurane (VAS) and surgery. 50% of group 3 patients complained study design details
for induction nausea patients complained of on discomfort
and maintenance discomfort associated
with induction of Group 1 was similar
anaesthesia (p < 0.05) with regard to patient
comfort and recovery
Macario et al., Quantification Rank 52% response rate. Variability in how Grade IV
1999, 186 USA of patients’ postoperative Vomiting was the least patients rated postpreferences
for outcomes from desirable outcome by operative outcomes. Survey
Survey postoperative most undesir- both ranking methodology Avoiding nausea/
anaesthesia able to least and relative value method- vomiting, incisional Provided an indication
outcomes undesirable ology. Previous experience pain, gagging on the of patients’ relative
with a certain anaesthesia endotracheal tube preferences for anaesthesia
outcome was not related was a high priority outcomes.Variability in
to a patient’s ranking for most patients patient preferences, but
of outcomes avoiding PONV was a
high priority
Myles et al., To develop a (1) Preoperative Found good convergent Developed and Testing the validity and
2000, 187
valid, reliable data: nine items validity between QoR-40 evaluated 40-item reliability of a recovery
Australia and responsive rated, then and VAS scores (ρ = 0.68; quality of recovery score to determine the
measure of the status on a p < 0.001). Construct score (QoR-40) in a quality of recovery after
Observational quality of three-point scale validity was by a negative diverse group of anaesthesia and surgery
study recovery after to give quality correlation with duration patients recovering
anaesthesia of recovery of hospital stay (ρ = –0.24; from many types of
score p < 0.001) and a lower surgery.Validity,
mean. Good test–retest reliability and clinical
(2) 40-item reliability. QoR-40 was acceptability of score
questionnaire completed in less than excellent
with items on a 6.3 (SD 4.9) min
five-point Likert
scale (QoR-40)
(3) Details of
surgery
(4) Postoperative
recovery (VAS)
Myles et al., Identify Rates of 10,811 patients were There was a high rate Grade IV
2000, 188
potentially satisfaction: reviewed on the day after of patient satisfaction
Australia modifiable satisfied, surgery to rate their within anaesthesia. Survey
factors somewhat satisfaction with care; Factors strongly
Survey associated with dissatisfied, satisfaction level was associated with The high rate of patient
dissatisfaction dissatisfied 96.8% and 2.3% were satisfaction included satisfaction may be an
somewhat dissatisfied. old patient age, male under-representation of the
Patients who were dis- sex, measures of true level of dissatisfaction.
satisfied were generally increased perioperative A large survey of surgical
younger and had a longer risk patients. Minor postduration
of anaesthesia. operative complications
Factors associated with
patient dissatisfaction were
postoperative pain, nausea,
vomiting and other
complications
are important to patients
continued