Table 5.
Degree of program implementation
| Program item | Pre-implementation | Post-implementation | Difference or RR (95% CI) | p-value | |
|---|---|---|---|---|---|
| 1. Duration of fasting (hours): median (Q1; Q3) | |||||
| Preoperative | 11.8 (9.92; 13.42) | 10.9 (7.67; 13.00) | Diff −0.83 (− 1.96, 0.29) | 0.147 | |
| Postoperative | 1.25 (0.82; 3.00) | 1.48 (0.80; 3.02) | Diff 0.25 (− 0.30, 0.80) | 0.368 | |
| 2. Spinal anesthesia: n (%) | 101 (88.6) | 103 (89.6) | RR 1.01 (0.92, 1.11) | 0.815 | |
| 3. General anesthesia: n (%) | 55 (47.7) | 44 (38.9) | RR 0.81 (0.60, 1.10) | 0.180 | |
| 4. Intraoperative antiemetic prophylaxis: n (%) | 45 (39.1) | 64 (55.7) | RR 1.53 (1.16, 2.02) | 0.003 | |
| PONV day 1 | 44 (38.3) | 30 (26.6) | RR 0.57 (0.43, 0.76)a | < 0.001 | |
| PONV day 2 | 21 (18.3) | 22 (19.1) | RR 0.84 (0.51, 1.40)a | 0.501 | |
| 5. Intraoperative tranexamic acid: n (%) | 68 (59.1) | 96 (83.5) | RR 1.41 (1.18, 1.68) | < 0.001 | |
| Intraoperative blood loss (ml): median (Q1; Q3) | 250 (150; 450) | 250 (150; 475) | Diff 0.00 (−66.2 to 66.2) | > 0.999 | |
| Blood transfusion day 1 | 3 (2.6) | 0 (0.0) | |||
| Blood transfusion day 2 | 4 (3.5) | 2 (1.7) | |||
| 6. Forced air warming: n (%) | 113 (98.3) | 114 (99.1) | RR 1.01 (0.98, 1.04) | 0.562 | |
| Fluid warming: n (%) | 110 (95.7) | 104 (90.4) | RR 0.95 (0.88, 1.02) | 0.123 | |
| PACU temperature (°C): mean (SD) | 35.6 (0.59) | 35.6 (0.52) | Diff −0.04 (−0.18, 0.11) | 0.611 | |
| 7. Oral analgesia: n (%) | |||||
| Paracetamol | Day 1 | 109 (94.8) | 114 (99.1) | RR 1.05 (1.00, 1.10) | 0.057 |
| Day 2 | 107 (93.0) | 114 (99.1) | RR 1.06 (1.01, 1.12) | 0.019 | |
| NSAIDs/cox2i | Day 1 | 50 (43.5) | 72 (62.6) | RR 1.44 (1.12, 1.85) | 0.005 |
| Day 2 | 59 (51.3) | 65 (56.5) | RR 1.10 (0.87, 1.40) | 0.429 | |
| Tramadol | Day 1 | 37 (32.2) | 41 (35.7) | RR 1.11 (0.77, 1.59) | 0.579 |
| Day 2 | 27 (23.7) | 23 (20.0) | RR 0.84 (0.52, 1.38) | 0.502 | |
| Gabapentinoids | Day 1 | 22 (19.1) | 34 (29.6) | RR 1.55 (0.97, 2.47) | 0.070 |
| Day 2 | 19 (16.7) | 31 (27.0) | RR 1.62 (0.97, 2.69) | 0.065 | |
| Intravenous analgesia: n(%) | |||||
| Opioid PCA | Day 1 | 5 (4.4) | 5 (4.4) | ||
| Day 2 | 2 (1.7) | 1 (0.87) | |||
| Ketamine | Day 1 | 1 (0.09) | 2 (1.7) | ||
| Day 2 | 1 (0.09) | 1 (0.09) | |||
| Epidural or nerve block: n(%) | 0 (0.0) | 4 (3.5) | |||
| 8. Cessation of intravenous fluid on day 1: n(%) | 96 (83.5) | 93 (80.9) | 1.13 (0.65, 1.97) | 0.673 | |
| 9. Postoperative physiotherapy assessment: n (%) | |||||
| Day 0 | 34 (29.6) | 66 (57.4) | RR 1.87 (1.36, 2.59) | < 0.001 | |
| Day 1 | 76 (66.1) | 113 (98.3) | RR 1.44 (1.26, 1.63) | < 0.001 | |
| Day 2 | 113 (98.3) | 114 (99.1) | RR 1.00 (0.98, 1.02) | 0.995 | |
| 10. Postoperative mobilisation ≥ 3 m: n (%) | |||||
| Day 0 | 10 (9.0) | 26 (22.6) | RR 2.51 (1.27, 4.97) | 0.008 | |
| Day 1 | 76 (68.5) | 94 (81.7) | RR 1.19 (1.02, 1.39) | 0.024 | |
| Day 2 | 99 (89.2) | 112 (97.4) | RR 1.09 (1.02, 1.17) | 0.016 | |
Abbreviations: PACU Post-anesthesia care unit, PCA Patient controlled analgesia, Q1 25th percentile, Q3 75th percentile
aadjusted for history of PONV