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

Abstract

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.