A prospective clinical audit to evaluate postoperative quality of recovery in adults at New Somerset Hospital, Cape Town, South Africa

Ally, Mwashungi; Cloete, Estie; Reed, Anthony

doi:10.7196/samj.2020.v110i10.14693

Cited by 3 publications

(4 citation statements)

References 19 publications

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“…The 25.1% worsening in the day 1 severe pain score is greater than in 3 other studies where a decline in the severe pain score was 6.2%, 35 12%, 26 and 15%, 36 respectively. In a South Africa context, Sikhakhane et al 21 found that 12% of patients complained specifically about postoperative pain in an open-comments section, while Ally et al 22 noted that postoperative pain negatively contributed toward their patient population’s QoR. From this, it can be surmised that postoperative pain is a major contributor toward poor QoR within a South African context.…”

Section: Discussionmentioning

confidence: 99%

“…15 This is important in a resource-constrained South African setting, where studies on QoR are limited. 21,22…”

mentioning

confidence: 99%

“…15 This is important in a resource-constrained South African setting, where studies on QoR are limited. 21,22 Orthopedic procedures account for a large proportion of surgical procedures in South Africa 23 and are expected to consume a large amount of health care resources. 24 Multiple factors such as surgical site, 25 regional nerve blocks, 3 sex, postoperative nausea and vomiting as well as pain, 13 have been found to influence the QoR within an orthopedic population.…”

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confidence: 99%

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Quality of Recovery Following Orthopedic Surgery in Patients at an Academic Hospital in South Africa

Wessels

Perrie

Scribante

et al. 2021

Anesthesia &Amp; Analgesia

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BACKGROUND: Measurement of perioperative quality of recovery (QoR) is an important tool in improving the patient’s perioperative experience. By making use of the Quality of Recovery-15 (QoR-15) questionnaire, this study aimed to measure the QoR on day 1 in patients following elective and semiurgent orthopedic surgery at an academic hospital. A secondary aim was to determine factors that may influence the QoR. METHODS: A cross-sectional research study was performed in 122 patients presenting for elective and semiurgent orthopedic surgery during core working hours between July and November 2019 at Helen Joseph Hospital, Johannesburg, South Africa. Patients completed a baseline QoR-15 assessment preoperatively and a day 1 QoR-15 assessment between 12 and 24 hours postoperatively. Additional information on various anesthetic, surgical, and patient factors was collected. RESULTS: Nineteen patients (15.6%) had a poor QoR on day 1 and were found to have started with a significantly worse baseline QoR-15 score than those with no poor QoR (98.5 vs 128.5; P < .001). A significant worsening from the overall mean baseline QoR-15 to the overall mean day 1 QoR-15 score was found (123.8 vs 113.1; P = .001). This worsening score was more pronounced in patients with a poor day 1 QoR-15 score than no poor day 1 score (25.3 vs 8; P = .002). Surgical site was found to have a significant effect on day 1 score (P = .026). A significantly worse severe pain score was found in patients with foot/ankle and knee surgery compared to hand/arm surgery (P = .012 and P = .032, respectively) and is thought to be due to the decreased use of peripheral nerve blocks in lower limb surgery. Sex, American Society of Anesthesiologists (ASA) physical status, type of anesthesia, postoperative analgesia, and antiemetic given (only applicable in general anesthetic cases) were not found to have a significant effect on the day 1 QoR-15 scores. CONCLUSIONS: Patients who had a poor QoR on day 1 started with a significantly worse baseline QoR-15 score and experienced a significantly greater negative change in the mean difference. Preoperative identification of patients who are at risk of a poor postoperative QoR may aid in preemptive targeting of limited resources to those who need them most. Postoperative pain, particularly in patients after foot/ankle and knee surgery, is a significant modifiable factor to improve postoperative QoR at our institution.

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Section: Discussionmentioning

confidence: 99%

“…15 This is important in a resource-constrained South African setting, where studies on QoR are limited. 21,22…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Quality of Recovery Following Orthopedic Surgery in Patients at an Academic Hospital in South Africa

Wessels

Perrie

Scribante

et al. 2021

Anesthesia &Amp; Analgesia

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“…48 Currently, instruments used to gauge pain severity include the Visual Analog Scale (VAS), the Numerical Rating Scale (NRS), the McGill Pain Questionnaire (MPQ) and the Brief Pain Inventory (BPI). 36,49 The VAS and NRS are unidimensional and only assess pain intensity. The two tools use a score based on the patient's self-reports of the presence and severity of their pain.…”

Section: Cause Analysis Inadequate Postoperative Pain Assessmentmentioning

confidence: 99%

Review of the Current Situation of Postoperative Pain and Causes of Inadequate Pain Management in Africa

Gao¹,

Mu²,

Lin³

et al. 2023

JPR

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Postoperative pain is one of the most prevalent complications following surgery, and more than 47% of surgical patients endure postoperative discomfort worldwide. In Africa, due to resource shortages and other issues, postoperative pain is substantially more common when compared to developed countries. Severe postoperative pain has many negative effects, including possibly death, which can burden both individuals and society as a whole. Therefore, effectively controlling postoperative pain is becoming increasingly important. To enhance the effectiveness of future pain management, a thorough analysis of the current reasons for inadequate postoperative pain management is necessary. In this article, the present situations of occurring postoperative pain, children's postoperative pain, and pain management in Africa are reviewed, based on relevant and recent literature. In particular, the reasons for inadequate postoperative pain management in Africa are detailed in this article from five perspectives: the inadequate assessment of postoperative pain, the knowledge gap among medical professionals, the patients' misconceptions, the scarcity of resources, and the lack of medications. Additionally, we offer appropriate solutions following various factors.

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Quality of recovery in the perioperative setting: A narrative review

Wessels

Perrie

Scribante

et al. 2022

Journal of Clinical Anesthesia

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A prospective clinical audit to evaluate postoperative quality of recovery in adults at New Somerset Hospital, Cape Town, South Africa

Abstract: This open-access article is distributed under Creative Commons licence CC-BY-NC 4.0.

Cited by 3 publications

References 19 publications

Quality of Recovery Following Orthopedic Surgery in Patients at an Academic Hospital in South Africa

Quality of Recovery Following Orthopedic Surgery in Patients at an Academic Hospital in South Africa

Review of the Current Situation of Postoperative Pain and Causes of Inadequate Pain Management in Africa

Quality of recovery in the perioperative setting: A narrative review

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