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A191
October 18, 2008
10:00 AM - 11:30 AM
Room Room 230D
Responsiveness of a Questionnaire Assessing Functional Recovery after Ambulatory Anesthesia
Jean Wong, M.D., F.R.C.P.C., Amir Abrishami, M.D., Yoshani De Silva, M.S., Doris Tong, M.D., F.R.C.P.C., Frances Chung, M.D., F.R.C.P.C.
Department of Anesthesia, Toronto Western Hospital, University of Toronto, Toronto, Ontario, Canada
Introduction: As more complex procedures on higher risk patients are performed as ambulatory surgery, it is increasingly important to evaluate patients' functional recovery after their hospital discharge 1. The purpose of this study was to assess the acceptability and responsiveness of a questionnaire which was developed and validated by the authors to assess patients' subjective post-discharge functional recovery after ambulatory anesthesia 2.

Methods: Ethics approval and informed consent was obtained from all participants. Patients who were scheduled for ambulatory surgery were included in the study. The questionnaire was administered preoperatively, and postoperatively by a telephone interview on postop day 1,3,5 and 7. The questionnaire includes 14 Likert-type questions related to three dimensions; pain and social activity, lower limb activity, and general physical activity. Each question has a numerical score from 0 to 10 with 0 indicating no difficulty and 10 extreme difficulty. Therefore a high score indicates greater difficulty with recovery. To evaluate the responsiveness of the questionnaire to change, the variability in the scores during the postop period and between different types of surgery was analyzed. In this regard, arthroscopy and microdiscectomy were considered as major surgery; dilatation and curettage (D&C) and eye procedures as minor surgery. Friedman's test for comparing repeated measures, and one-way ANOVA for comparison between the scores at each point of time. SPSS 16.0 and Graph Pad Prism 5 were used for analysis.

Results: One hundred consecutive patients undergoing ambulatory surgery were included in the study. Follow-up was complete for all patients. The Friedman's test showed that there is a significant difference between the preop score and postop day 1, 3, and 7 (all p <0.001) but not postop day 5 (p=ns, Figure 1), because the scores returned to baseline by postop day 5. One-way ANOVA of the scores also showed that there is a difference between the scores among the major and minor surgical procedures at each point of time (Figure 2), however the statistical significance (p <0.05) was shown only at preop and postop day 5 assessments. The time to complete the questionnaires was similar at different times and on average ranged between 4:10 to 4:35 (min:sec).

Conclusions: The questionnaire demonstrated good responsiveness to detect the changes in functional recovery during the postoperative period and between different types of ambulatory procedures. The questionnaire could be completed in less than 5 min, indicating good acceptability of the questionnaire as a practical tool to assess recovery after ambulatory surgery.

References:1. JAMA.272:619-26. 2. Can J Anesth 2005 52: A74.[figure1][figure2]

Anesthesiology 2008; 109 A191
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