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Abstract(s)
Introdução e objectivos: Recobro pós-operatório é um processo
dinâmico complexo de retorno à normalidade e integridade, relacionado com a
reaquisição do controlo de funções físicas, psicológicas e sociais, após uma
intervenção cirúrgica. A avaliação da qualidade de recobro anestésico é
fundamental na apreciação dos cuidados de saúde prestados, bem como da
satisfação do doente.
O nosso objectivo primário consistiu em determinar a influência do tipo
de anestesia - geral vs. bloqueio subaracnoideu - na qualidade de recobro.
Tipo de estudo: Estudo observacional prospectivo, realizado no
Hospital Sousa Martins.
Métodos: Após autorização da Comissão de Ética da Unidade de Saúde
Local da Guarda e obtenção de consentimento informado por escrito,
estudámos uma amostra constituída por 87 doentes, de ambos os sexos, com
idades igual ou superior a 18 e inferior a 75 anos, sujeitos a cirurgia electiva
nas áreas de Cirurgia Geral (n = 46), Ortopedia (n = 21) e Ginecologia (n = 20),
sob anestesia geral (n = 78) ou bloqueio subaracnoideu (n = 9). Para a avaliação da qualidade de recobro foi utilizado o questionário
QoR-40, aplicado pelos investigadores 24 horas antes e 24 horas depois da
cirurgia. Uma ficha individual foi completada com os dados referenciados no
processo clínico.
Resultados: Os 78 doentes submetidos a anestesia geral apresentaram
50 ± 14 anos de idade (média ± desvio-padrão), sendo que 51 (65%) eram
mulheres. No caso dos 9 doentes submetidos a bloqueio subaracnoideu, 5
homens e 4 mulheres (p = 0,280), a média de idades foi superior (59 ± 12 anos
de idade; p = 0,048).
Verificou-se que não havia diferença na qualidade de recobro, entre os
diferentes tipos de anestesia, independentemente do momento da aplicação do
questionário - pré-operatório: 186 (10) no grupo da anestesia geral e 187 (19)
no do bloqueio subaracnoideu, p = 0,906; pós-operatório: 170 (23) e 180 (17), p
= 0,122 (dados como mediana e distância interquartis).
Conclusão: Os dados que encontrámos no número de doentes que
estudámos sugerem que não existem diferenças na qualidade de recobro em
função do tipo de anestesia utilizado - geral vs. bloqueio subaracnoideu - tendo
os doentes apresentado, no global, uma boa qualidade de recobro com ambos. O carácter preliminar deste estudo impõe, contudo, a sua continuação
posterior com envolvimento de um número mais elevado de doentes.
Background and Objectives: Post-operative recovery is a complex dynamic process of returning to normality and integrity, associated with reacquisition of control over physical, psychological and social functions, after a surgical intervention. The assessment of the quality of the recovery period is very important in the evaluation of health care and patient’s satisfaction. In this study we aimed to assess the influence of anesthesia type – general vs. subarachnoid blockade - in quality of recovery. Design of Study: Observational prospective study, done in Hospital Sousa Martins. Methods: After obtaining authorization of the Ethics Committee of the Guarda’s Local Health Unity and patient informed written consent, we study a group of 87 patients, of both gender, with ages equal or superior to 18 and inferior to 75 years, proposed to elective surgery in General Surgery (n = 46), Orthopedics (n = 21) and Gynecology (n = 20) under general anesthesia (n = 78) or subarachnoid blockade (n = 9) To evaluate quality of recovery we used the QoR-40 questionnaire, applied by the investigators 24 hours before and 24 hours after the surgery. An individual card was completed with data from clinical files. Results: The 78 patients under general anesthesia presented 50 ± 14 years old (mean ± standard-deviation), 51 of which (65%) were women. In the case of the 9 patients under subarachnoid blockade, 5 men and 4 women (p = 0,280), the average age was superior (59 ± 12 years old, p = 0,048). We found that there was no difference in quality of recovery, between the two types of anesthesia, independently of questionnaire application timing – pre-operatory: 186 (10) in the general anesthesia group and 187 (19) in the subarachnoid blockade group, p = 0,906; post-operatory: 170 (23) and 180 (17), p = 0,122 (data as median and interquartile range). Conclusion: In our study population, we conclude that there were no differences in the quality of recovery depending on the type of anesthesia, general vs. subarachnoid blockade. The patients presented, globally, a good quality of recovery with both types of anesthesia. The preliminary character of this study demands its subsequent continuation with the involvement of a larger number of patients.
Background and Objectives: Post-operative recovery is a complex dynamic process of returning to normality and integrity, associated with reacquisition of control over physical, psychological and social functions, after a surgical intervention. The assessment of the quality of the recovery period is very important in the evaluation of health care and patient’s satisfaction. In this study we aimed to assess the influence of anesthesia type – general vs. subarachnoid blockade - in quality of recovery. Design of Study: Observational prospective study, done in Hospital Sousa Martins. Methods: After obtaining authorization of the Ethics Committee of the Guarda’s Local Health Unity and patient informed written consent, we study a group of 87 patients, of both gender, with ages equal or superior to 18 and inferior to 75 years, proposed to elective surgery in General Surgery (n = 46), Orthopedics (n = 21) and Gynecology (n = 20) under general anesthesia (n = 78) or subarachnoid blockade (n = 9) To evaluate quality of recovery we used the QoR-40 questionnaire, applied by the investigators 24 hours before and 24 hours after the surgery. An individual card was completed with data from clinical files. Results: The 78 patients under general anesthesia presented 50 ± 14 years old (mean ± standard-deviation), 51 of which (65%) were women. In the case of the 9 patients under subarachnoid blockade, 5 men and 4 women (p = 0,280), the average age was superior (59 ± 12 years old, p = 0,048). We found that there was no difference in quality of recovery, between the two types of anesthesia, independently of questionnaire application timing – pre-operatory: 186 (10) in the general anesthesia group and 187 (19) in the subarachnoid blockade group, p = 0,906; post-operatory: 170 (23) and 180 (17), p = 0,122 (data as median and interquartile range). Conclusion: In our study population, we conclude that there were no differences in the quality of recovery depending on the type of anesthesia, general vs. subarachnoid blockade. The patients presented, globally, a good quality of recovery with both types of anesthesia. The preliminary character of this study demands its subsequent continuation with the involvement of a larger number of patients.
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Keywords
Anestesia Anestesia geral - Recobro - Avaliação da qualidade Bloqueio subaracnoideu
Citation
Publisher
Universidade da Beira Interior