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Patient Perceptions of Regional Anesthesia: Influence of Gender, Recent Anesthesia Experience, and Perioperative Concerns
  1. Paris Dove, MBBS*,,
  2. Fiona Gilmour, MBChB, FRCA,
  3. William M. Weightman, MBChB, FANZCA*, and
  4. Graham Hocking, MBChB, DMCC, FRCA, FANZCA, FFPMANZCA,
  1. From the *The University of Western Australia;
  2. Sir Charles Gairdner Hospital;
  3. School of Medicine and Pharmacology, The University of Western Australia, Perth, Western Australia.
  1. Address correspondence to: Graham Hocking, MBChB, DMCC, FRCA, FANZCA, FFPMANZCA, Sir Charles Gairdner Hospital, Perth, Western Australia 6009 (e-mail: graham.hocking{at}anaesthesia.uwa.edu.au).

Abstract

Background and Objectives: Anesthesiologists often find that patients would prefer a general anesthetic (GA) to a regional anesthetic (RA) for surgery. We surveyed patients' attitudes to RA in an Australian tertiary-care hospital, hoping to understand the reasons for acceptance or refusal. We explored how 3 main factors influence the patient's choice for subsequent RA: gender, type of anesthetic on the day of surgery, and perioperative concerns.

Methods: Consecutive patients at a single institution were interviewed on the first postoperative day by a research nurse, either as a face-to-face interview or by telephone after ambulatory surgery. A short description of RA and GA was given, and preferences for future anesthesia and concerns were recorded.

Results: Complete data were obtained from 1000 patients. More women preferred GA compared with men (76.3% vs 69.0%). Patients who received only RA during their surgery on the previous day were almost 3 times more likely to express a future preference for RA compared with those who received any GA, using hypothetical examples of arm or hip surgery (83.2% vs 21.1%, P = 0.00001). Patients expressed more concerns about hearing or seeing the surgery than experiencing a complication, and 84% preferred sedation.

Conclusions: More patients, especially females, may accept RA if reassured appropriately about not hearing or seeing the surgery. Once patients have experienced RA, they are more likely to choose it in future. Modification of our discussion and consent process may increase the uptake of RA techniques.

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Footnotes

  • There is no financial support received for this study.

  • Parts of the data were presented as a poster at the NYSORA World Congress, Dubai, March 2010, and the Australian New Zealand College of Anaesthetists Annual Scientific Meeting, Christchurch, New Zealand, May 2010.

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