Using the post‐operative quality recovery scale to evaluate recovery with different neuromuscular blocking reversal agentsin the Portuguese population ‐ interim analysis results: 1AP3‐8

Abstract

Background and Goal of Study: Post-operative Quality Recovery Scale (PQRS), is the first scale evaluating several domains of postoperative recovery. The objectives of this study were to compare overal and physiologic, cognitive, and functional domains of post-operative recovery af ter elective surgical procedures using neostigmine or sugammadex as neuromuscular blocking (NMB) reversal agents, to validate the use of PQRS in the Portuguese population and to objectively assess muscular strength recovery. Materials and Methods: Prospective multicenter observational study comparing postoperative recovery between 2 cohorts of 50 adult patients submitted to elective surgical procedures with general anesthesia using Nondepolarizing Muscle Relaxants and NMB reversal with neostigmine or sugammadex. Measurements obtained using Portuguese version of PQRS at dif ferent timepoint: baseline,15 minutes (T15), 40 minutes (T40), one and three days af ter surgery. Full recovery defined as return to values identical or higher than those measured at baseline, prior to surgery. Muscular strength measured with KERN- MAP® Dynamometer. Ethics Committees approval was obtained. Statistics used linear T-Test, Qui Square and Fisher exact test, data presented as mean±SD for continuous variables. Interim analysis results presented Results and Discussion: Thirty patients received neostigmine and 21 sugammadex. Age and BMI 50.4±11.8 and 28.6±5.6 in the neostigmine group and 38.2±12.7 and 24.7± 4.5 in the sugammadex group (p< 0,001). Overall response rate at T15 was 86% for neostigmine and 95% for sugammadex (p= 0.22). Dif ferences in favor of sugammadex group noted in nociceptive and emotional domains, 80 vs 100% respectively (p=0.04). Overall response rate at T40 was 80% for neostigmine and 65% for sugammadex (p=0.33), primarily reflecting constraints on activities of daily life. Muscular strength did not dif fer. Improvements in recovery scores from T15 to T40 were observed in both groups, without significant dif ferences . Postoperative assessments were feasible using PQRS at T15 and T40 and seem appropriate for comparisons between postoperative recovery domains and overall recovery . These preliminary results suggest nociceptive and emotional domains recovery at T15 may be faster with sugammadex. Conclusion: The results support the adopted PQRS validation process and the potential of this scale as a tool for the evaluation of post operative recovery evaluation in the Portuguese populatio