Article Text
Abstract
Please confirm that an ethics committee approval has been applied for or granted: Not relevant
Background and Aims The ambulatory pathway for upper limb trauma surgery at cork University Hospital has incorporated ultrasound guided regional anaesthesia as the principal anaesthesia modality. The anaesthesia model of care incorporates: single shot axillary brachial plexus block (AxBPB); perioperative dexamethasone; and postoperative multimodal oral analgesia. The aim of this service evaluation was to ascertain an objective assessment of patient experience.
Methods A prospective audit was performed during March and April 2024. Thirty non-consecutive patients opportunistically sampled, undergoing ambulatory upper limb surgery under AxBPB were included. Patients were contacted by telephone 2 days postoperatively. Patient satisfaction was measured using a 6 point likert scale (0-5) to evaluate satisfaction with anaesthesia, analgesia and their overall experience with the ambulatory care pathway. A priori threshold score of greater than or equal to 4 was defined as the audit standard. Patient data was compared with historical non-paired controls (2022) to evaluate pathway performance over time under two tail Mann Whitney U test.
Results Median [range] satisfaction scores were 5 [4-5], 5 [3-5], 5 [3-5] for anaesthesia, analgesia and overall ambulatory experiences. When compared to historical controls (2022), no significant difference was found. P-value were 0.4913, 0.2151, 0.4913 in anaesthesia, analgesia and overall ambulatory experiences. No perioperative and post-operative complication noticed.
Conclusions Patient satisfaction is high for this ambulatory upper limb soft tissue trauma pathway enhanced by regional anaesthesia. Patient satisfaction was similar to historical controls, suggesting sustainability of the pathway over time, notwithstanding changes in personnel frequently encountered in a university teaching hospital setting.