Chhabra Alka, Dave Milan, Jeenger Lalita, Meena Reena, Aggarwal Ila, Partani Seema
Department of Anaesthesia and Critical Care, Geetanjali Medical College and Hospital, Udaipur, Rajasthan, India.
Department of Anaesthesia and Critical Care, H.J. Doshi Hospital, Rajkot, Gujarat, India.
Indian J Anaesth. 2023 Apr;67(4):388-393. doi: 10.4103/ija.ija_479_22. Epub 2023 Apr 10.
Recovery from surgery and anaesthesia is usually observed through conventional indicators. The Quality of Recovery (QoR-15) score was specially designed to measure psychometric and functional recovery from the patient's perspective. This study aimed to evaluate QoR-15 following the administration of intravenous (IV) lignocaine or IV fentanyl in patients undergoing septoplasty surgery.
This randomised, controlled trial was conducted on 64 patients of American Society of Anesthesiologists (ASA) physical status I and II, of either sex, of ages between 18 and 60 years, and who were scheduled for septoplasty. The primary end point was to compare the quality of recovery following the administration of IV lignocaine(group L) and IV fentanyl (group F) using the QoR-15 score in patients undergoing septoplasty. Secondary end points were to compare postoperative analgesia, recovery characteristics, and adverse effects in both groups. Statistical analysis was done using the Shapiro-Wilk test, paired test/ Wilcoxon signed-rank test, and unpaired test/Mann-Whitney test. A -value <0.05 was considered statistically significant.
There was a significant improvement in the postoperative QoR-15 score than in the preoperative score in both groups ( < 0.000). However, the postoperative QoR-15 score was significantly higher in group L compared to group F ( < 0.001). Total consumption of analgesic doses were reduced in group L (=0.000). Time taken to achieve an Aldrete score >9 and gastrointestinal recovery was shorter in group L compared to group F.
Both IV lignocaine and IV fentanyl improved postoperative QoR-15 score; however, lignocaine had a higher postoperative QoR-15 score than fentanyl, in addition to showing early discharge readiness, better analgesia, and better recovery profile in patients following septoplasty surgery.
手术和麻醉后的恢复通常通过传统指标来观察。恢复质量(QoR - 15)评分是专门为从患者角度衡量心理和功能恢复而设计的。本研究旨在评估在鼻中隔成形术患者中静脉注射(IV)利多卡因或静脉注射芬太尼后QoR - 15的情况。
本随机对照试验纳入了64例美国麻醉医师协会(ASA)身体状况为I级和II级、年龄在18至60岁之间、计划进行鼻中隔成形术的患者,性别不限。主要终点是使用QoR - 15评分比较鼻中隔成形术患者静脉注射利多卡因组(L组)和静脉注射芬太尼组(F组)后的恢复质量。次要终点是比较两组的术后镇痛、恢复特征和不良反应。采用Shapiro - Wilk检验、配对t检验/ Wilcoxon符号秩检验和非配对t检验/ Mann - Whitney U检验进行统计分析。P值<0.05被认为具有统计学意义。
两组术后QoR - 15评分均较术前有显著改善(P < 0.000)。然而,L组术后QoR - 15评分显著高于F组(P < 0.001)。L组的镇痛药物总消耗量减少(P = 0.000)。与F组相比,L组达到Aldrete评分>9的时间和胃肠道恢复时间更短。
静脉注射利多卡因和静脉注射芬太尼均能改善术后QoR - 15评分;然而,利多卡因术后QoR - 15评分高于芬太尼,此外,在鼻中隔成形术患者中,利多卡因还表现出更早达到出院标准、更好的镇痛效果和更好的恢复情况。