Patient perceptions of regional anesthesia: influence of gender, recent anesthesia experience, and perioperative concerns.

Abstract

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. 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. 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. 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.