Day-case anaesthesia: what would the patient prefer?

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Abstract:

The objective of this study was to identify patients' and parents' preferences for anaesthesia in a large sample of adult and paediatric day-surgery patients from two hospitals in the North West of England who had participated in a randomised controlled trial (RCT) of different anaesthetic techniques.

The study consisted of telephone interviews up to one week postoperatively. Of the recruited sample, 907 (85%) adults and 260 parents/guardians (81%) were contacted by telephone. Of these, 694 (77%) adult patients and 132 (51%) children received an intravenous induction, and 213 (24%) adult patients and 128 (49%) children received an inhalational induction.

Fifty-nine parents and 226 adults refused to be in the RCT because there was a 50% chance of the child and 25% chance of the adult being randomised to the inhalational induction arm. Patients who had an intravenous induction were more likely to rate the experience as 'pleasant' compared to an inhalational induction (P<0.0005). Twenty-four percent of adults and 37% of parents reported discomfort from the injection. Seventeen percent of adults and 37% of parents who had a inhalation induction reported some discomfort with the mask. Forty-four percent of adults and 66% of parents/guardians who had an inhalational induction this time said they would prefer it if they required a surgical procedure in future. Only 6% of adults and 13% of parents/guardians who had an intravenous induction this time would prefer an inhalational induction next time.

Patients and parents had strong preferences for modes of anaesthesia. Inhalational induction was unpopular with adult patients and parents of paediatric patients. Experience of this technique improved acceptability considerably.

Keywords: DAY-CASE ANAESTHESIA; DAY-CASE SURGERY; PATIENT PREFERENCES

Document Type: Regular Paper

Publication date: January 1, 2004

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