The 8-item Short-Form Health Survey and the physical comfort composite score of the quality of recovery 40-item scale provide the most responsive assessments of pain, physical function, and mental function during the first 4 days after ambulatory knee surgery with regional anesthesia.
BACKGROUND
We evaluated the validity and responsiveness of three instruments: the numeric rating scale (NRS) pain score, the 8-item Short-Form Health Survey (SF-8), and the 40-item Quality of Recovery from Anesthesia (QoR) Survey in 154 outpatients undergoing anterior cruciate ligament reconstruction (ACLR). The objective was to provide a robust psychometric basis for outcome survey selection for surgical outpatients undergoing regional anesthesia without general anesthesia.


METHODS
Patients undergoing ACLR with a standardized spinal anesthesia plan were randomized to receive a perineural catheter with either placebo injection-infusion, or injection-infusion with levobupivacaine. Patients completed the NRS, SF-8, and QoR instruments for four postoperative days to evaluate pain, physical function, and mental function.


RESULTS
Regarding pain, neither the NRS nor the QoR offered advantages over the SF-8. Regarding physical function, the QoR physical independence composite offered no advantage over the SF-8 physical component summary. The QoR physical comfort composite assessed short-term changes in treatment-related side effects, and thus provided information not covered by the SF-8. Regarding mental function, the SF-8 mental component summary and QoR emotional state composite showed little change over the four days, although the latter measure showed higher responsiveness to change.


CONCLUSIONS
For ACLR outpatients receiving regional anesthesia, the SF-8 is sufficient to assess postoperative pain and physical function. Adding the QoR physical comfort composite will help assess short-term side effects.
Center for Research on Health Care, and Department of Anesthesiology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania 15213, USA. bostje@upmc.edu
James E
JE
Bost
Brian A
BA
Williams
Matthew T
MT
Bottegal
Qianyu
Q
Dang
Doris M
DM
Rubio
D000293:Adolescent; D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000523:psychology; D000765:Anesthesia, Conduction; D016118:Anterior Cruciate Ligament / Q000601:surgery*; D005260:Female; D006306:Health Surveys; D006801:Humans; D008297:Male; D010146:Pain / Q000175:diagnosis / Q000523:psychology; D010147:Pain Measurement / Q000379:methods* / Q000523:psychology / Q000592:standards; D011788:Quality of Life / Q000523:psychology; D020127:Recovery of Function / Q000502:physiology*; D013997:Time Factors