Utilities of the Post-anesthesia State derived by the Standard Gamble method in surgical patients

Saifudin Rashiq,Diane Edlund,Bruce D Dick

doi:10.1186/1472-6947-6-8

Saifudin Rashiq, Diane Edlund + Show 1 more

Open Access

https://doi.org/10.1186/1472-6947-6-8

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Abstract

BackgroundThere are no published utilities for the post-anesthesia state obtained by the standard gamble method (SG).MethodsWe obtained utilities for postoperative pain, nausea, vomiting, urinary retention and myalgia from 100 adults prior to elective surgery using SG.Results20% of volunteer participants could not demonstrate a satisfactory understanding of the SG process. Median utilities for each adverse effect were all very close to 1.0, and no statistically significant differences were found between them.ConclusionOur results suggest that the avoidance of anesthesia related side effects and pain is not viewed by patients prior to surgery as being worthy of the taking of even a miniscule risk of death. This may affect the decision to utilize anesthesia techniques that trade a lower incidence of common side effects for a very low but finite risk of a catastrophic complication.

Highlights

There are no published utilities for the post-anesthesia state obtained by the standard gamble method (SG)
21 were excluded, either because they did not give an appropriate response to the screening lotteries (16) or were unable to complete the protocol for some other reason (5)
100 subjects completed the study by providing indifference probabilities for some or all the adverse effects under investigation

Summary

Introduction

There are no published utilities for the post-anesthesia state obtained by the standard gamble method (SG). Anesthesia can be given in a wide variety of different ways. Many operations can either be performed under general anesthesia, regional anesthesia (targeted blockade with local anesthetic of the nerves supplying the area to be operated on) or local anesthesia. Even within these broad classifications, a number of drugs, techniques and routes of administration may be used alone or together in a large number of potential combinations. The rates of catastrophic complication related to anesthesia have not been reduced to zero (Kaufman et al 2000)

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