Evidence Based Practice and Quality Assurance
Background and Goal of Study: Intra-operative and post-operative adverse outcomes have been identified as the major causes of dissatisfaction with anesthesia. The aim of this study was to identify patient preferences for post-operative anaesthesia outcomes in our population.
Materials and Methods: 100 pre-operative adult patients were given standardized preoperative information about anaesthesia. Each patient was asked to prioritize 11 possible anesthesia outcomes using a relative value scale (willingness to pay out of a total of 100 Euro). Each outcome was described in simple language. Peri-operative management was at the discretion of the anaesthesia provider. 26 medical and paramedical staff members also completed the survey.
Results and Discussions: 100 patients (mean age 44.77 ± 18.01) responded. 87 were undergoing elective and 13 emergency surgery. Patient rankings (from highest to lowest avoidance priority) were; vomiting, pain, breathing tube sensation, nausea, disorientation, bladder fullness, sore throat, shivering, thirst, itch, drowsiness. Broad variation was seen. Staff rankings for perceived patient preferences were; pain, vomiting, nausea, breathing tube, bladder fullness, disorientation, shivering, thirst, drowsiness, sore throat and itch. Willingness to pay was similar except for nausea (Staff vs. Patient, €16.7 ± 12.4 vs. €8.7 ± 18.8, p = 0.008).
Conclusion(s): There is broad correlation between medical staff and patient perceptions of desired outcomes. Individualized approaches to patient care are mandated by the wide variation is patient preferences.
1 Macario A, Weinger M, Carney S, Kim A. Which clinical anesthesia outcomes are important to avoid? The perspective of patients. Anesth Analg. 1999 Sep;89(3):652-8.