Brazilian Journal of Anesthesiology
Brazilian Journal of Anesthesiology
Clinical Research

Effect of anesthetic technique on the quality of anesthesia recovery for abdominal histerectomy: a cross-observational study

Efeito da técnica anestésica na qualidade da recuperação da anestesia para histerectomia abdominal: estudo observacional transversal

Daniel de Carli, José Fernando Amaral Meletti, Rodrigo Pauperio Soares de Camargo, Larissa Schneider Gratacós, Victor Cristiano Ramos Gomes, Nicole Dutra Marques

Downloads: 0
Views: 666


Spinal anesthesia combined with sedation and general anesthesia combined with epidural are two techniques often used for patients undergoing abdominal hysterectomy. There is no consensus that one of these techniques is superior regarding the perception of patients towards the quality of postoperative recovery. This observational cross-sectional study aimed to assess the quality of postoperative recovery in women undergoing open abdominal hysterectomy by comparing both anesthetic techniques.

We recruited 162 women aged between 30 and 74 years to be submitted to abdominal hysterectomy. The anesthetic technique used followed the preference of the attending anesthesiologist without interference of the investigators. After applying the exclusion criteria, 80 patients underwent spinal anesthesia combined with sedation (Group 1) and 62 women underwent epidural anesthesia combined with general anesthesia (Group 2). The quality of postoperative recovery was evaluated using the questionnaire Quality of Recovery-40 (QoR-40) completed 24 hours after the end of the surgery.

Eighty patients in Group 1 answered the QoR-40 questionnaire with an average rating of 179.4 points, median of 186.5, standard deviation of 17.4 and a confidence interval of 3.8. The 60 patients in Group 2 answered the QoR-40 with an average of 174.9 points, median of 178 points, standard deviation of 16 points and a confidence interval of 4.0 (p = 0.024).

Women who received spinal anesthesia combined with sedation considered quality of postoperative recovery better.


Postoperative period,  Patient satisfaction,  Quality of Health Care,  Anesthesia,  Anesthesia recovery period


1 M.C.B. Melo, É.N.D. Barros Histerectomia e simbolismo do útero: possíveis repercussões na sexualidade feminina Rev SBPH, 12 (2009), pp. 80-99

2 W.K. Lee, M.S. Kim, S.W. Kang, M.S. Kim, J.R. Lee Type of anaesthesia and patient quality of recovery: a randomized trial comparing propofol-remifentanil total i.v. anaesthesia with desflurane anaesthesia Br J Anaesth, 114 (2015), pp. 663-668

3 S. Poitras, P. Beaule, G.F. Dervin Validity of a short-term quality of life questionnaire in patients undergoing joint replacement: the Quality of Recovery-40 J Arthroplasty, 27 (2012), pp. 1604-1608

4 K.B. Kluivers, I. Riphagen, M.E. Vierhout, H.A. Brölmann, H.C. de Vet Systematic review on recovery specific quality-of-life instruments Surgery, 143 (2008), pp. 206-215

5 G.S. Murphy, J. Szokol, S.B. Greenberg, et al. Preoperative dexamethasone enhances quality of recovery after laparoscopic cholecystectomy: effect on in-hospital and postdischarge recovery Anesthesiology, 114 (2011), pp. 882-890

6 F.F. Estivalet, A. Bagatini, C.R. Gomes Remifentanil associated to propofol or sevoflurane for videolaparoscopic cholecystectomy: a comparative study Rev Bras Anestesiol, 52 (2002), pp. 385-393

7 P.S. Myles, B. Weitkamp, K. Jones, J. Melick, S. Hensen Validity and reliability of a postoperative quality of recovery score: the QoR-40 Br J Anaesth, 84 (2000), pp. 11-15

8 P.S. Myles, J.O. Hunt, C.E. Nightingale, et al. Development and psychometric testing of a quality of recovery score after general anesthesia and surgery in adults Anesth Analg, 88 (1999), pp. 83-90

9 B.F. Gornall, P.S. Myles, C.L. Smith, et al. Measurement of quality of recovery using the QoR-40: a quantitative systematic review Br J Anaesth, 111 (2013), pp. 161-169

10 A.H.A. Eduardo, CB Santos, A.M.P. Carvalho, E.C. Carvalho Validation of the Brazilian version of the Quality of Recovery - 40 Item questionnaire Acta Paul Enferm, 29 (2016), pp. 253-259

11 L.G. Pereira, M. Costa, G. Sousa, F. Abelha Quality of recovery after anaesthesia measured with QoR-40: a prospective observational study Braz J Anesthesiol, 66 (2016), pp. 369-375

12 T. Mihara, T. Ishii, K. Ka, T. Goto Effects of steroids on quality of recovery and adverse events after general anesthesia: meta-analysis and trial sequential analysis of randomized clinical trials PLoS One, 11 (2016), Article e0162961

13 E.T. Moro, M.A. Silva, M.G. Couri, D.D. Issa, J.M. Barbieri Quality of recovery from anesthesia in patients undergoing orthopedic surgery of the lower limbs Rev Bras Anestesiol, 66 (2016), pp. 642-650

14 P.S. Myles, D.B. Myles, W. Galagher, C. Chew, N. MacDonald, A. Dennis Minimal clinically important difference for three quality of recovery scales Anesthesiology, 125 (2016), pp. 39-45

15 A. Ali, D. Altun, B.H. Oguz, M. Ilhan, F. Demircan, K. Koltka The effect of preoperative anxiety on postoperative analgesia and anesthesia recovery in patients undergoing laparascopic cholecystectomy J Anesth, 28 (2014), pp. 222-227

16 C.L. Wu, A.J. Rowlingson, A.W. Partin, et al. Correlation of postoperative pain to quality of recovery in the immediate postoperative period Reg Anesth Pain Med, 30 (2005), pp. 516-522

17 C. Kubulus, K. Schmitt, N. Albert, et al. Awake, sedated or anaesthetised for regional anaesthesia block placements?: a retrospective registry analysis of acute complications and patient satisfaction in adults Eur J Anaesthesiol, 33 (2016), pp. 715-724

18 C.F. Royse, F. Chung, S. Newman, J. Stygall, D.J. Wilkinson Predictors of patient satisfaction with anaesthesia and surgery care: a cohort study using the Postoperative Quality of Recovery Scale Eur J Anaesthesiol, 30 (2013), pp. 106-110

19 P.S. Myles, D.L. Williams, M. Hendrata, H. Anderson, A.M. Weeks Patient satisfaction after anaesthesia and surgery: results of a prospective survey of 10,811 patients Br J Anaesth, 84 (2000), pp. 6-10

20 L.J.S. Castro-Alves, V.L.F. De Azevedo, T.F.D.F. Braga, A.C. Goncalves, et al. The effect of neuraxial versus general anesthesia techniques on postoperative quality of recovery and analgesia after abdominal hysterectomy: a prospective, randomized, controlled trial Anesth Analg, 113 (2011), pp. 1480-1486

21 D. Pöpping, N. Elia, H. Van Aken, et al. Impact of epidural analgesia on mortality and morbidity after surgery: systematic review and meta-analysis of randomized controlled trials Annals Surg, 259 (2014), pp. 1056-1067

22 N. Elkassabany, L.F. Cai, S. Mehta, et al. Does regional anesthesia improve the quality of postoperative pain management and the quality of recovery in patients undergoing operative repair of tibia and ankle fractures? J Orthopaedic Trauma, 29 (2015), pp. 404-409

23 F.W. Abdallah, P.J. Morgan, T. Cil, et al. Ultrasound-guided multilevel paravertebral blocks and total intravenous anesthesia improve the quality of recovery after ambulatory breast tumor resection Anesthesiology, 120 (2014), pp. 703-713

24 S Schraag, L Pradelli, Ajo Alsaleh, et al. Propofol vs. inhalational agents to maintain general anaesthesia in ambulatory and in-patient surgery: a systematic review and meta-analysis BMC Anesthesiol, 18 (2018), p. 162

60981f63a953954f782a6ac2 rba Articles
Links & Downloads

Braz J Anesthesiol

Share this page
Page Sections