Postoperative Quality of Recovery

Project Details

Professor Colin Royse has developed a novel assessment tool that can asses the quality of recovery after surgery that can be repeated at multiple time-points including after discharge home from hospital. This tool is increasingly becoming popular for evaluation of surgery and as a valuable research tool. Professor Royse is the chair of the Postop QRS committee and overseas many projects and higher research degree students in this rapidly growing area of research.

Central to the practice of perioperative medicine and patient centred care are the abstract ideals of quality and recovery, neither of which have a universally accepted definition or assessment tool. Recovery definitions have progressed from an historical emphasis on short-term restitution of purely physiological parameters to a multidimensional concept, which includes physiological, nociceptive, emotive, functional and cognitive domains. With an ageing, ambulant perioperative population and an increasing understanding of the interplay between physiological stress and neurophysiology, there is increased importance of cognitive assessment. Current recovery assessment tools vary in their validation and differ in their assessment of recovery as a dichotomous vs. continuous variable, and at the individual vs. group level. Ideally, quality of recovery would be defined as a return of a patient’s function to their own baseline or better and assessed in multiple domains and over multiple time points. The ideal recovery assessment tool would allow real-time assessment of recovery with facility to identify in which sub-domain recovery has failed, in both individual patients and at a population level, thus allowing both clinical time critical interventions and research applications.


Professor Colin Royse, Co-director, Ultrasound Education Group


Professor S Newman, London

Dr Andrea Bowyer, RMH

Research Publications

  1. Bowyer A, Jakobsson J, Ljungqvist O, Royse C A review of the scope and measurement of postoperative quality of recovery. Anaesthesia 2014; 69: 1266-78.
  2. Bowyer A, Royse C The importance of postoperative quality of recovery: influences, assessment, and clinical and prognostic implications. Can J Anaesth 2016; 63: 176-83.
  3. Bowyer AJ, Royse CF Postoperative recovery and outcomes--what are we measuring and for whom? Anaesthesia 2016; 71 Suppl 1: 72-7.
  4. Lindqvist M, Royse C, Brattwall M, Warren-Stomberg M, Jakobsson J Post-operative Quality of Recovery Scale: the impact of assessment method on cognitive recovery. Acta Anaesthesiol Scand 2013; 57: 1308-12.
  5. Liu J, Yuan W, Wang X, et al. Peripheral nerve blocks versus general anesthesia for total knee replacement in elderly patients on the postoperative quality of recovery. Clin Interv Aging 2014; 9: 341-50.
  6. Newman S, Wilkinson DJ, Royse CF Assessment of early cognitive recovery after surgery using the Post-operative Quality of Recovery Scale. Acta Anaesthesiol Scand 2014; 58: 185-91.
  7. Royse C Epidurals for cardiac surgery: can we substantially reduce surgical morbidity or should we focus on quality of recovery? Anesthesiology 2011; 114: 232-3.
  8. Royse CF, Chung F, Newman S, Stygall J, Wilkinson DJ Predictors of patient satisfaction with anaesthesia and surgery care: a cohort study using the Postoperative Quality of Recovery Scale. Eur J Anaesthesiol 2013; 30: 106-10.
  9. Royse CF, Newman S, Williams Z, Wilkinson DJ A human volunteer study to identify variability in performance in the cognitive domain of the postoperative quality of recovery scale. Anesthesiology 2013; 119: 576-81.
  10. Royse CF, Williams Z, Purser S, Newman S Recovery after nasal surgery vs. tonsillectomy: discriminant validation of the Postoperative Quality of Recovery Scale. Acta Anaesthesiol Scand 2014; 58: 345-51.
  11. Royse CF, Williams Z, Ye G, et al. Knee surgery recovery: Post-operative Quality of Recovery Scale comparison of age and complexity of surgery. Acta Anaesthesiol Scand 2014; 58: 660-7.

Research Group

Ultrasound Education Group

Faculty Research Themes


School Research Themes

Neuroscience & Psychiatry, Musculoskeletal , Critical Care

Key Contact

For further information about this research, please contact the research group leader.

Department / Centre


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