title: [Quality of recovery from anesthesia in patients undergoing orthopedic surgery of the lower limbs].
abstract: OBJECTIVE
  For patients undergoing regional anesthesia for orthopedic surgery, a common situation in our work environment, the quality of recovery may be influenced in different ways, which justifies studies to identify possible predictive factors of dissatisfaction. The aim of this study was to assess the opinion of patients on recovery from anesthesia for lower limb orthopedic surgeries. We also identified potential predictive factors for poor quality of recovery.
  
  
  METHODS
  We evaluated patients undergoing lower limb orthopedic surgeries and able to participate in the study. Data related to surgery, anesthesia, possible complications in the post-anesthetic care unit (PACU) and in the ward were recorded. In the morning after surgery, patients were evaluated by a medical student who applied the QoR-40 questionnaire. The resulted score-between 40 and 200-was used to determine the quality of recovery and identify the potential predictors.
  
  
  RESULTS
  We evaluated 172 patients. The questionnaire average score was 192 points. The chance to have lower scores in the QoR-40 was two times higher among males. Patients who remained under sedation, classified as greater than or equal to 4 on the scale proposed by Ramsay, had a 3.5 times higher risk of having lower scores in the QoR-40 compared to those who remained with level 1 or 2 of sedation. Regarding pain, at every increase of one unit in the numerical scale (0-10), there was a 19% increase in risk for QoR-40 ≤ 195. Similarly, the risk for a score below the median was 2.3 times higher among those presenting with nausea and/or vomiting in the ward.
  
  
  CONCLUSIONS
  Male, nausea, vomiting, pain while in the ward, and deeper levels of sedation are possible predictive factors for lower scores according to the adopted instrument.
authors.affiliation: Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba, SP, Brazil. Electronic address: eduardo_moro@terra.com.br.
authors.forename: Eduardo Toshiyuki
authors.initials: ET
authors.lastname: Moro
authors.affiliation: Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba, SP, Brazil.
authors.forename: Manoel Arthur Nóbrega da
authors.initials: MA
authors.lastname: Silva
authors.affiliation: Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba, SP, Brazil.
authors.forename: Marcelo Gouvêa
authors.initials: MG
authors.lastname: Couri
authors.affiliation: Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba, SP, Brazil.
authors.forename: Danielle da Silva
authors.initials: DD
authors.lastname: Issa
authors.affiliation: Faculdade de Ciências Médicas e da Saúde, Pontifícia Universidade Católica de São Paulo (PUC-SP), Sorocaba, SP, Brazil.
authors.forename: Julia Morais
authors.initials: JM
authors.lastname: Barbieri
keywords: Anestesia; Anesthesia; Complications; Complicações; Orthopedics; Ortopedia; Patient satisfaction; Questionnaire; Questionário; Satisfação do paciente