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Abstract(s)
Introdução: O Recobro Anestésico é um período importante dentro da globalidade do procedimento cirúrgico e anestésico, que pode ser avaliado segundo diferentes perspectivas. A satisfação e a qualidade de recobro, segundo o ponto de vista do doente, têm-se tornado importantes indicadores de resultados dos Cuidados de Saúde assim como têm assumido um papel relevante na avaliação dos Serviços de Anestesiologia.
O QoR-40 fornece uma avaliação eficiente e extensa da qualidade de recobro dos doentes após anestesia e cirurgia, sendo útil como medida em estudos clínicos perioperatórios, tendo já sido validado para a população portuguesa.
Objectivo: Comparar, no que respeita à qualidade de recobro percepcionada pelo paciente, os efeitos da cirurgia realizada em ambulatório com os da cirurgia com internamento.
Materiais e métodos: Estudo observacional realizado de forma prospectiva. Com uma amostra constituída por 115 doentes de ambos os sexos, com idades entre 18 e os 80 anos, submetidos a cirurgia electiva e anestesia geral na Unidade Local de Saúde da Guarda. Oitenta e seis (Grupo I) encontravam-se internados nos Serviços de Cirurgia Geral, Ortopedia e Ginecologia e 29 (Grupo II) foram intervencionados no âmbito da Unidade de Cirurgia de Ambulatório (cujos procedimentos cirúrgicos abrangem as especialidades de Cirurgia Geral, Ortopedia e Gastrenterologia). Após aprovação da Comissão de Ética da ULS da Guarda e obtido o Consentimento livre e informado por escrito, o QoR-40 foi por nós aplicado antes e depois da cirurgia. A Ficha individual foi preenchida tendo por base o Processo Clínico de cada doente.
Resultados: Após aplicação dos critérios de exclusão, 81 doentes encontravam-se em regime de internamento, sendo a sua idade média 51,6±14,4 anos e com uma predominância do sexo feminino (65%). Vinte e nove doentes foram intervencionados na Unidade de Cirurgia de Ambulatório, cuja idade média foi de 51,0±15,7 anos (p=0,91) e a percentagem de doentes do sexo feminino era igual a 62% (p=0,82). Em ambos os grupos a Cirurgia Geral foi o tipo de cirurgia mais representativo.
No período pré-operatório não se encontram diferenças estatisticamente significativas entre os doentes intervencionados em cirurgia com internamento e os em Cirurgia de Ambulatório (p=0,242), excepto na dimensão Apoio ao doente (p=0,0002). Pelo contrário, no que diz respeito ao período pós-operatório, a diferença entre os dois grupos é estatisticamente significativa para todas as dimensões assim como para o total (p=<0,00001).
Discussão: A qualidade de recobro percepcionada pelo doente, diminui de forma significativa entre 24 horas antes do acto operatório e 24 horas depois deste ter terminado, nos doentes de cirurgia com internamento, mas não nos doentes em Cirurgia de Ambulatório.
Introduction: The anesthesia recovery period is an important step of the surgical procedure and anesthesia, and it can be evaluated from different perspectives. According to the patients’ point of view, the satisfaction and the quality of the recovery have become important outcome indicators of healthcare and have assumed an important role in the evaluation of the anesthesiology services. The QoR-40 – a tool validated for the Portuguese population - provides an efficient and comprehensive evaluation of the patients’ recovery after anesthesia and surgery. Aim of the study: Compare the consequences of the inpatient surgery to the ones of the ambulatory surgery as far as the quality of the recovery perceived by the patient is concerned. Methodology: Observational study with a sample of 115 individuals, whose ages ranged from 18 to 80 years old. Eighty six patients (Group I) were hospitalized in general surgery, orthopedics and gynecology and 29 (Group II) were submitted to an ambulatory surgery, which included the specialties of general surgery, orthopedics and gastroenterology. After the approval of the ethics committee of the Unidade Local de Saúde da Guarda and once obtained the free and informed consent of the patients, the qor-40 was applied before and after the surgery. The patient sheet was filled out based on the clinical history of each patient. Results: After applying the exclusion criteria, we concluded that 81 patients were inpatients and their average age was 51.6 ± 14.4 years. There was a female predominance (65%). Twenty nine (29) patients were submitted to surgery in the ambulatory surgery unit, and their average age was 51.0±15.7 years (p=0,91). Once again, there was a majority (62%) of female patients (p=0,82). The general surgery was the most representative type of surgery in both groups. In the preoperative period there are not statistically significant differences between the hospitalized patients and the patients submitted to an ambulatory surgery (p=0,242), with the exception of the patient support (p=0,0002). On the other hand, as far as the postoperative period is concerned, the difference between the two groups is statistically significant for all the dimensions as well as for the total (p<0,00001). Discussion: The quality of the recovery perceived by the patient decreases significantly between the 24 hours before the surgery and the following 24 hours regarding the inpatients. The same does not happen with the patients from ambulatory surgery.
Introduction: The anesthesia recovery period is an important step of the surgical procedure and anesthesia, and it can be evaluated from different perspectives. According to the patients’ point of view, the satisfaction and the quality of the recovery have become important outcome indicators of healthcare and have assumed an important role in the evaluation of the anesthesiology services. The QoR-40 – a tool validated for the Portuguese population - provides an efficient and comprehensive evaluation of the patients’ recovery after anesthesia and surgery. Aim of the study: Compare the consequences of the inpatient surgery to the ones of the ambulatory surgery as far as the quality of the recovery perceived by the patient is concerned. Methodology: Observational study with a sample of 115 individuals, whose ages ranged from 18 to 80 years old. Eighty six patients (Group I) were hospitalized in general surgery, orthopedics and gynecology and 29 (Group II) were submitted to an ambulatory surgery, which included the specialties of general surgery, orthopedics and gastroenterology. After the approval of the ethics committee of the Unidade Local de Saúde da Guarda and once obtained the free and informed consent of the patients, the qor-40 was applied before and after the surgery. The patient sheet was filled out based on the clinical history of each patient. Results: After applying the exclusion criteria, we concluded that 81 patients were inpatients and their average age was 51.6 ± 14.4 years. There was a female predominance (65%). Twenty nine (29) patients were submitted to surgery in the ambulatory surgery unit, and their average age was 51.0±15.7 years (p=0,91). Once again, there was a majority (62%) of female patients (p=0,82). The general surgery was the most representative type of surgery in both groups. In the preoperative period there are not statistically significant differences between the hospitalized patients and the patients submitted to an ambulatory surgery (p=0,242), with the exception of the patient support (p=0,0002). On the other hand, as far as the postoperative period is concerned, the difference between the two groups is statistically significant for all the dimensions as well as for the total (p<0,00001). Discussion: The quality of the recovery perceived by the patient decreases significantly between the 24 hours before the surgery and the following 24 hours regarding the inpatients. The same does not happen with the patients from ambulatory surgery.
Description
Keywords
Cirurgia ambulatória Cirurgia com internamento Recobro anestésico - Qualidade de vida
Citation
Publisher
Universidade da Beira Interior