Abstract
BackgroundAnesthesia side effects are almost inevitable in most situations. In order to optimize the anesthetic experience from the patient's viewpoint, it makes intuitive sense to attempt to avoid the side effects that the patient fears the most.MethodsWe obtained rankings and quantitative estimates of the relative importance of nine experiences that commonly occur after anesthesia and surgery from 109 patients prior to their surgery and from 30 anesthesiologists.ResultsPain was the most important thing to avoid, and subjects allocated a median of $25 of an imaginary $100 to avoiding it. Next came vomiting ($20), nausea ($10), urinary retention ($5), myalgia ($2) and pruritus ($2). Avoiding blood transfusion, an awake anesthetic technique or postoperative somnolence was not given value by the group as a whole. Anesthesiologists valued perioperative experiences in the same way as patients.ConclusionsOur results are comparable with those of previous studies in the area, and suggest that patients can prioritize the perioperative experiences they wish to avoid during their perioperative care. Such data, if obtained in the appropriate fashion, would enable anesthetic techniques to be compared using decision analysis.
Highlights
Anesthesia side effects are almost inevitable in most situations
Surgery and anesthesia result in the development of pain, nausea and other adverse effects
In order to provide the most satisfactory outcome to the person experiencing the process, it makes intuitive sense to try to understand which adverse outcomes are most disliked by patients and to incorporate these preferences into the design of perioperative care
Summary
In order to optimize the anesthetic experience from the patient's viewpoint, it makes intuitive sense to attempt to avoid the side effects that the patient fears the most. Macario et al [1] obtained rankings for 10 states such as pain, nausea, somnolence and sore throat that might be experienced after general anesthesia from 101 patients prior to surgery using an anonymous questionnaire. They found that vomiting, gagging on the endotracheal tube, pain and nausea were the least desirable outcomes in descending order of importance. Subjects completed the questionnaires without direct assistance from the (page number not for citation purposes)
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