Development and evaluation of an obstetric quality-of-recovery score (ObsQoR-11) after elective Caesarean delivery

Ciechanowicz, S.; Setty, T.; Robson, Elizabeth B.; Sathasivam, C.; Chazapis, Maria; Dick, John R.; Carvalho, Brendan; Sultan, Pervez

doi:10.1016/j.bja.2018.06.011

Cited by 90 publications

(99 citation statements)

References 18 publications

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“…Breast milk volume grading was set by the experimental researcher as follows: I, no milk was produced; II, breast milk cannot meet the feeding needs of newborns; III, breast milk can meet the feeding needs of newborns; and IV, there is breast milk surplus after feeding the newborn. Moreover, we used the Hospital Anxiety and Depression Scale (HADS) 19 and obstetric quality-ofrecovery score (ObsQoR-11) 20 to measure baseline characteristics and changes in maternal mood and recovery quality before surgery and on days 1 and 2 after surgery. We also measured the General Comfort Questionnaire (GCQ) 21 on the third day after delivery to assess comfort during the hospital stay.…”

Section: Outcomes and Measurementsmentioning

confidence: 99%

<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

Wang

Fang

Liu

et al. 2020

DDDT

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Objective: Few studies have investigated the effects of dexmedetomidine (DEX) on breastfeeding after cesarean delivery. A randomized double-blind controlled trial was conducted to investigate whether the administration of DEX, immediately after delivery and for patient-controlled intravenous analgesia (PCIA), can be beneficial for breastfeeding. Patients and Methods: One hundred sixty parturients scheduled for elective cesarean section under spinal anesthesia were randomly allocated to the DEX group (a loading dose of DEX was pumped at 0.5 μg/kg within 10 min, followed by a further infusion of DEX at 0.5 μg/kg/h until the end of the surgery and PCIA for 2 days with DEX plus sufentanil) or the standard care group (infusion saline intraoperatively, and PCIA for 2 days with sufentanil). The number of days required to switch to exclusive breastfeeding within six weeks of delivery, the time to first lactation and breast milk volume on day 1 and day 2 after delivery were recorded. Recovery quality, comfort, anxiety, depression, postoperative analgesia, and adverse reactions of parturients were also assessed. Results: Compared with the standard care group, parturients in the DEX group could be converted to exclusive breastfeeding earlier (11 [14] vs 8 [10] days, log-rank P=0.025), the first lactation time was sooner (28.38 [13.82] vs 33.79 [14.85] hrs, P=0.024), and the amount of breast milk on the second day after delivery increased (P=0.012). There was no difference between the two groups in postpartum uterine contraction pain, but postpartum rest and movement VAS scores and recovery quality score in the DEX group were better than those in the standard care group (all P<0.05). Moreover, the hospital anxiety and depression scale and anxiety subscale score on the second day after delivery and the comfort score on the third day after delivery in the DEX group were significantly better than those in the standard care group (5 [5] vs 6 [8], 2 [2] vs 3 [3], 83.58 [6.75] vs 80.48 [6.58]; P=0.013, P=0.005, P=0.006, respectively). The incidence of adverse events, such as bradycardia, vomiting, hypersomnia, hypertension and hypotension, was not significantly different between the DEX and standard care groups (6.9% vs 2.7%, 5.6% vs 13.7%, 4.2% vs 0%, 5.6% vs 2. 7%, 11.1% vs 8.2%; P=0.275, P=0.158, P=0.366, P=0.681, P=0.556, respectively), except more parturients experienced nausea in the standard care group than in the DEX group (28.8% vs 11.1%, P=0.012). Furthermore, there was no difference in Neonatal Behavioral Neurological Assessment scores on the first and second days after delivery between the DEX and standard care groups (38 [3] vs 37 [2], 38.5 [2] vs 38 [2]; P=0.173, P=0.312, respectively). Conclusion: The application of DEX in the perioperative period of cesarean section was not only conducive to the early conversion of infant feeding to exclusive breastfeeding but could also improve the recovery quality and comfort of the parturient, optimize analgesia, shorten the time to first lactation, and increase lactation.

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Section: Outcomes and Measurementsmentioning

confidence: 99%

<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

Wang

Fang

Liu

et al. 2020

DDDT

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“…The recovery quality of parturients within 24 h after surgery was assessed by obstetric quality of recovery-11 score [18] (ObsQoR-11, score from 0-10 in each term, where 0 = strongly agree and 10 = strongly disagree, the higher of the score, the higher of recovery quality), which was designed for parturients and presented by Ciechanowicz S; intra-and postoperative adverse events including nausea, vomiting and shivering, time to the rst analgesic request and total sufentanil comsumption at 24 h after surgery were also recorded. Parturients were contacted by telephone for a post-operative 30 days following discharge to determine whether nerve injury occurred, including any new onset of back, buttock or leg pain or paresthesia.…”

Section: Discussionmentioning

confidence: 99%

“…Currently, the commonly used postoperative recovery quality scales were QoR-40 [25] and QoR-15 [26] . However, both of them are developed and veri ed in non-obstetric patients and day surgery population [27] , so there are many items unrelated to cesarean section, and lack of critical elements to evaluate postoperative recovery after delivery such as the ability of caring babies [18] . The ObsQoR-11 scale has been proved to be reliable, clinically acceptable, feasible and effective in patients undergoing elective and emergency cesarean section [18,28] .…”

Section: Discussionmentioning

confidence: 99%

“…However, both of them are developed and veri ed in non-obstetric patients and day surgery population [27] , so there are many items unrelated to cesarean section, and lack of critical elements to evaluate postoperative recovery after delivery such as the ability of caring babies [18] . The ObsQoR-11 scale has been proved to be reliable, clinically acceptable, feasible and effective in patients undergoing elective and emergency cesarean section [18,28] . In our study, all questionnaire feedback had been received and the results showed that scores in group DB was higher than in both group FB and group B (P< 0.017), suggesting that parturients with intrathecal DEX had a better recovery quality.…”

Section: Discussionmentioning

confidence: 99%

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The efficacy and safety of intrathecal dexmedetomidine for parturients undergoing cesarean section: a double-blind randomized controlled trial

et al. 2020

Preprint

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Background : The efficacy and safety of spinal anesthesia by intrathecal dexmedetomidine (DEX) for parturients undergoing cesarean section are still lack of evidence. This aim of our study was to evaluate the efficacy and safety of intrathecal DEX for parturients undergoing cesarean section to provide more data evidence for intrathecal applications.Methods : Three hundred parturients undergoing cesarean section under spinal anesthesia were randomly assigned into three groups : group B: 9.0 mg (1.2 ml) of 0.75% bupivacaine with saline (1 ml); group FB: 9.0 mg (1.2 ml) of 0.75% bupivacaine with 20 μg of fentanyl (1 ml); group DB: 9.0 mg (1.2 ml) of 0.75% bupivacaine with 5 μg of DEX (1 ml). Intraoperative block characteristics, parturients’ postoperative quality of recovery, maternal and neonatal outcomes and the plasma concentration of DEX were measured. All parturients were followed up for 30 days to determine whether nerve injury occurred.Results : Compared with group B, the duration of sensory block in group FB and group DB were significantly prolonged (108.4 min [95% Confidence Interval (CI)=104.6-112.3] in group B, and 122.0 min [95% CI=116.8-127.3] in group FB, 148.2 min [95% CI=145.3-151.1] in group DB). The overall score of quality recovery in group DB (71.6 [95% CI=71.0-72.2]) was significantly higher than that in group FB (61.5 [95% CI=60.8-62.2]) and group B (61.7 [95% CI=61.0-62.4]). There was no statistically significant difference among the three groups for PH, PaO2, and PaCO2 of newborn. The plasma concentration of DEX in umbilical artery and umbilical vein was low and cannot be detected. The 30-days follow-up of parturients did not show any new onset of back, buttock or leg pain or paresthesia.Conclusions : DEX is a potential local anesthetic adjuvant that the intrathecal combination of 5 μg DEX can safely exhibit a facilitatory block effect and improve parturients' recovery quality.Trial registration : Chinese Clinical Trial Registry (Registration number # ChiCTR1900022019; Date of Registration on March 20th, 2019).

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“…Hospital stays were shortest in the women who received dexmedetomidine before and during delivery. Long hospital stays are correlated with poor recovery in women who undergo cesarean delivery [ 16 ] and administration of dexmedetomidine before the procedure improves quality of life in these patients.…”

Section: Discussionmentioning

confidence: 99%

Retrospective Comparison of the Safety and Effectiveness of Dexmedetomidine Versus Standard of Care Before and During Cesarean Delivery in a Maternity Unit in Zhengzhou, China

Wei

Wang

et al. 2020

Med Sci Monit

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Development and evaluation of an obstetric quality-of-recovery score (ObsQoR-11) after elective Caesarean delivery

Cited by 90 publications

References 18 publications

<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

<p>Impact of Intraoperative Infusion and Postoperative PCIA of Dexmedetomidine on Early Breastfeeding After Elective Cesarean Section: A Randomized Double-Blind Controlled Trial</p>

The efficacy and safety of intrathecal dexmedetomidine for parturients undergoing cesarean section: a double-blind randomized controlled trial

Retrospective Comparison of the Safety and Effectiveness of Dexmedetomidine Versus Standard of Care Before and During Cesarean Delivery in a Maternity Unit in Zhengzhou, China

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