Open AccessHealth‐related quality of life and postoperative recovery in fast‐track hysterectomy
Author(s) -
WODLIN NINNIE BORENDAL,
NILSSON LENA,
KJØLHEDE PREBEN
Publication year - 2011
Publication title -
acta obstetricia et gynecologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.401
H-Index - 102
eISSN - 1600-0412
pISSN - 0001-6349
DOI - 10.1111/j.1600-0412.2010.01058.x
Subject(s) - medicine , sick leave , hysterectomy , quality of life (healthcare) , fast track , abdominal hysterectomy , randomized controlled trial , population , health related quality of life , anesthesia , surgery , physical therapy , disease , nursing , environmental health
Objective. To determine whether health‐related quality of life (HRQoL) and postoperative recovery of women who undergo abdominal hysterectomy in a fast‐track program under general anesthesia (GA) differ from women who receive spinal anesthesia with intrathecal morphine (SA). Design . Secondary analysis from an open randomized controlled multicenter study. Setting. Five hospitals in south‐east Sweden. Population. One hundred and eighty women admitted for abdominal hysterectomy for benign disease were randomized; 162 completed the study, 80 with GA and 82 with SA. Methods. The HRQoL was measured preoperatively using the EuroQoL EQ‐5D and the Short‐Form‐36 health survey (SF‐36) questionnaires. The EQ‐5D was used daily for 1 week; thereafter, once weekly for 4 weeks and again 6 months after operation. The SF‐36 was completed at 5 weeks and 6 months. Dates of commencing and ending sick leave were registered. Main Outcome Measures. Changes in HRQoL; duration of sick leave. Results. The HRQoL improved significantly faster in women after SA than after GA. Sick leave was significantly shorter after SA than after GA (median 22.5 vs. 28 days). Recovery of HRQoL and duration of sick leave were negatively influenced by postoperative complications. In particular, the mental component of HRQoL was negatively affected by minor complications, even 6 months after the operation. Conclusions. Spinal anesthesia with intrathecal morphine provided substantial advantages in fast‐track abdominal hysterectomy for benign gynecological disorders by providing faster recovery and shorter sick leave compared with general anesthesia.