Qualidade da recuperação pós-operatória em pacientes submetidos à colecistectomia por videolaparoscopia em hospital universitário

Abstract

Postoperative recovery (PR) is a complex, multifactorial process, resulting largely from the confluence of physical, physiological, and psychological factors that result in improvement or reestablishment of a preoperative status both from the perspective of the assisting team and also from the patient's perspective. The primary objective of the study is to use the QoR-15 questionnaire tool to describe and compare the preoperative and 24-hour postoperative score (day-1) in patients undergoing elective laparoscopic cholecystectomy (LC) surgery. This is a cross-sectional, single-center study carried out on patients undergoing elective LC surgery, aged 18-70 years, who in the pre-anesthetic evaluation received ASA Physical Status classification I-III. Patients were asked to answer the QoR-15 during hospitalization, preoperatively, and 24 hours postoperatively after the surgical procedure. Additional information such as age, sex, weight, height, body mass index (BMI), preoperative fasting time, type of anesthesia (general, regional, or combined—general and regional), analgesic medications used intraoperatively and postoperatively, duration of anesthesia, duration of surgery, type of surgery (oncological or non-oncological), and antiemetics used were collected for comparison purposes. Data normality was checked using the Kolmogorov-Smirnov test. Wilcoxon, Cohen's Kappa K, Fisher's exact, Kruskal-Wallis, and Mann-Whitney statistical tests were used when appropriate. Data from 116 patients were analyzed. In our hospital, the postoperative QOR-15 was 136.00 (IQR: 20.2), scoring in the excellent category. However, there was no statistically significant difference in relation to the preoperative QoR-15 score of 135.00 (IQR: 18.0), p = 0.4803. When analyzing the postoperative score in a categorized way, there was a statistically significant difference between the variables gender (p-value: 0.0052) and anesthetic technique (p-value: 0.0462). In all the months analyzed, the median postoperative QoR-15 was above the moderate recovery category. In our reality, we identified that patients presented an excellent quality of postoperative recovery, and that the anesthetic technique used and the patient's gender may be associated with the quality of this recovery.