Article ; Online: Comparison of the Quality of Recovery-15 score in patients undergoing oncoplastic breast-conserving surgery under monitored anesthesia care versus general anesthesia: a prospective quality improvement study.
Canadian journal of anaesthesia = Journal canadien d'anesthesie
2023 Volume 70, Issue 12, Page(s) 1928–1938
Abstract: Purpose: Whether changing the institutional practice from general anesthesia (GA) to monitored anesthesia care (MAC) affects postoperative quality of recovery for oncoplastic breast-conserving surgery (BCS) is currently unknown. We designed this quasi- ... ...
| Title translation | Comparaison du score de Qualité de la récupération 15 chez les patientes subissant une chirurgie mammaire conservatrice oncoplastique sous sédation procédurale par rapport à une anesthésie générale : une étude prospective d’amélioration de la qualité. | |||||
|---|---|---|---|---|---|---|
| Abstract | Purpose: Whether changing the institutional practice from general anesthesia (GA) to monitored anesthesia care (MAC) affects postoperative quality of recovery for oncoplastic breast-conserving surgery (BCS) is currently unknown. We designed this quasi-experimental study to evaluate a quality improvement (QI) initiative instituted in Edmonton, AB, Canada. Methods: We chose a prospective controlled cohort study design for this QI study, where patients underwent oncoplastic BCS under MAC in one hospital and BCS under GA at another hospital (control). A total of 125 patients undergoing surgery between May 2021 and February 2022 were enrolled. Exclusion criteria were male sex, total mastectomy, or age under 18. All other patients were included. The primary outcome was the change in Quality of Recovery-15 score at 24 hr compared with a preoperative baseline. Secondary outcomes included intra- and postoperative time profiles, perioperative analgesic and antiemetic use and length of hospital stay. Statistical analysis included a propensity score analysis to account for confounding variables. Results: Sixty-four patients received GA and 61 MAC. No enrolled patients were lost to follow up but two were excluded secondarily. No patients receiving MAC needed conversion to GA or unplanned airway management. Monitored anesthesia care was associated with superior outcomes for the primary outcome (β/SE[β], 3.31; 99.5% confidence interval, 0.45 to 6.17; P = 0.001) and most secondary outcomes, when accounting for confounding factors. Conclusions: A care transformation initiative for patients undergoing oncoplastic BCS under MAC was associated with a higher quality recovery profile and shorter length of stay without any increase in perioperative or postoperative adverse events. |
|||||
| MeSH term(s) | Humans ; Male ; Female ; Prospective Studies ; Cohort Studies ; Mastectomy, Segmental ; Breast Neoplasms/surgery ; Breast Neoplasms/etiology ; Quality Improvement ; Mastectomy ; Anesthesia, General/adverse effects ; Retrospective Studies ; Treatment Outcome | |||||
| Language | English | |||||
| Publishing date | 2023-09-25 | |||||
| Publishing country | United States | |||||
| Document type | Journal Article | |||||
| ZDB-ID | 91002-8 | |||||
| ISSN | 1496-8975 ; 0832-610X | |||||
| ISSN (online) | 1496-8975 | |||||
| ISSN | 0832-610X | |||||
| DOI | 10.1007/s12630-023-02567-3 | |||||
| Shelf mark |
|
|||||
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
Full text online
More links
Kategorien
In stock of ZB MED Cologne/Königswinter
| Zs.A 109: Show issues | Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG) |
Order via subito
This service is chargeable due to the Delivery terms set by subito. Orders including an article and supplementary material will be classified as separate orders. In these cases, fees will be demanded for each order.