Patient satisfaction after carotid endarterectomy using a selective policy of local anesthesia
Background: Patient satisfaction after carotid endarterectomy has not been specifically studied or reported. Results of carotid endarterectomy using either local or general anesthesia have been widely reported, and outcomes are not significantly different for either technique. Patient satisfaction d...
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| Veröffentlicht in: | The American journal of surgery 2000-05, Vol.179 (5), p.382-385 |
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| description | Background: Patient satisfaction after carotid endarterectomy has not been specifically studied or reported. Results of carotid endarterectomy using either local or general anesthesia have been widely reported, and outcomes are not significantly different for either technique. Patient satisfaction data were obtained in order to determine whether patients preferred one method of anesthesia over another. Data regarding outcome may be added to the surgical literature as benchmark data when comparing operative carotid endarterectomy to newer techniques.
Methods: During a 30-month period, 186 consecutive carotid endarterectomies were performed on 169 patients by a single surgeon with assistance from senior surgical residents. All patients were offered local anesthesia using a cervical block technique with intraoperative supplementation. Patients for whom local anesthesia was inappropriate or who declined were operated on using general endotracheal anesthesia. Results of operation were tabulated including indication for operation, method of anesthesia, intraoperative and postoperative complications, and mortality, and completion of a patient satisfaction survey form either on postoperative visit or by telephone questionnaire.
Results: Of 169 patients who underwent carotid endarterectomy, 151 (89%) completed the satisfaction survey form. One hundred fourteen (62%) had local anesthesia and 71 patients (38%) had general anesthesia. There was 1 stroke (0.5%) and 1 death (0.5%) in the series. Perioperative complications including temporary cranial nerve injury, neck hematoma, myocardial infarction, and restenosis were noted and not significantly different in either the general anesthesia or local anesthesia group. Patient satisfaction data including intraoperative discomfort, postoperative pain, attentiveness of the operating room staff, and length of stay were all tabulated. There was no statistically significant difference in satisfaction between the general anesthesia group and the local anesthesia group (chi-square and Fisher’s exact test). Additionally, satisfaction with the procedure was extremely high.
Conclusions: Patient outcome and perception of pain and recovery were not statistically significantly different in patients undergoing carotid endarterectomy using local anesthesia compared with general anesthesia. Overall patient satisfaction was extremely high. Patients should be offered carotid endarterectomy using an anesthesia technique with which the surge |
| doi_str_mv | 10.1016/S0002-9610(00)00371-8 |
| format | Article |
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Methods: During a 30-month period, 186 consecutive carotid endarterectomies were performed on 169 patients by a single surgeon with assistance from senior surgical residents. All patients were offered local anesthesia using a cervical block technique with intraoperative supplementation. Patients for whom local anesthesia was inappropriate or who declined were operated on using general endotracheal anesthesia. Results of operation were tabulated including indication for operation, method of anesthesia, intraoperative and postoperative complications, and mortality, and completion of a patient satisfaction survey form either on postoperative visit or by telephone questionnaire.
Results: Of 169 patients who underwent carotid endarterectomy, 151 (89%) completed the satisfaction survey form. One hundred fourteen (62%) had local anesthesia and 71 patients (38%) had general anesthesia. There was 1 stroke (0.5%) and 1 death (0.5%) in the series. Perioperative complications including temporary cranial nerve injury, neck hematoma, myocardial infarction, and restenosis were noted and not significantly different in either the general anesthesia or local anesthesia group. Patient satisfaction data including intraoperative discomfort, postoperative pain, attentiveness of the operating room staff, and length of stay were all tabulated. There was no statistically significant difference in satisfaction between the general anesthesia group and the local anesthesia group (chi-square and Fisher’s exact test). Additionally, satisfaction with the procedure was extremely high.
Conclusions: Patient outcome and perception of pain and recovery were not statistically significantly different in patients undergoing carotid endarterectomy using local anesthesia compared with general anesthesia. Overall patient satisfaction was extremely high. Patients should be offered carotid endarterectomy using an anesthesia technique with which the surgeon and patients are both comfortable, having confidence that the outcome is not related to anesthesia technique and that patients will be highly satisfied.</description><identifier>ISSN: 0002-9610</identifier><identifier>EISSN: 1879-1883</identifier><identifier>DOI: 10.1016/S0002-9610(00)00371-8</identifier><identifier>PMID: 10930485</identifier><identifier>CODEN: AJSUAB</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Aged ; Anesthesia ; Anesthesia, General - adverse effects ; Anesthesia, General - psychology ; Anesthesia, Local - adverse effects ; Anesthesia, Local - methods ; Anesthesia, Local - psychology ; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Asymptomatic ; Biological and medical sciences ; Carotid arteries ; Cerebral infarction ; Chi-Square Distribution ; Choice Behavior ; Complications ; Coronary vessels ; Cost analysis ; Cranial nerves ; Drugs ; Endarterectomy, Carotid - adverse effects ; Endarterectomy, Carotid - psychology ; Female ; General anesthesia ; Heart surgery ; Hematoma ; Hospitals ; Humans ; Length of stay ; Length of Stay - statistics & numerical data ; Local anesthesia ; Local anesthesia. Pain (treatment) ; Male ; Medical residencies ; Medical sciences ; Myocardial infarction ; Pain ; Pain perception ; Pain, Postoperative - etiology ; Patient Satisfaction ; Postoperative ; Practice Guidelines as Topic ; Restenosis ; Retrospective Studies ; Statistical analysis ; Stroke ; Surgeons ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surveys ; Surveys and Questionnaires ; Time Factors ; Treatment Outcome ; Variables ; Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><ispartof>The American journal of surgery, 2000-05, Vol.179 (5), p.382-385</ispartof><rights>2000 Excerpta Medica Inc.</rights><rights>2000 INIST-CNRS</rights><rights>2000. Excerpta Medica Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c418t-d22841952b634f09bae24b8570bbc34e6d9e2b1b2b283a1013abe6743db5b11e3</citedby><cites>FETCH-LOGICAL-c418t-d22841952b634f09bae24b8570bbc34e6d9e2b1b2b283a1013abe6743db5b11e3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002961000003718$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>309,310,314,776,780,785,786,3537,23909,23910,25118,27901,27902,65534</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=1478879$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/10930485$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Quigley, Terence M</creatorcontrib><creatorcontrib>Ryan, William R</creatorcontrib><creatorcontrib>Morgan, Shawn</creatorcontrib><title>Patient satisfaction after carotid endarterectomy using a selective policy of local anesthesia</title><title>The American journal of surgery</title><addtitle>Am J Surg</addtitle><description>Background: Patient satisfaction after carotid endarterectomy has not been specifically studied or reported. Results of carotid endarterectomy using either local or general anesthesia have been widely reported, and outcomes are not significantly different for either technique. Patient satisfaction data were obtained in order to determine whether patients preferred one method of anesthesia over another. Data regarding outcome may be added to the surgical literature as benchmark data when comparing operative carotid endarterectomy to newer techniques.
Methods: During a 30-month period, 186 consecutive carotid endarterectomies were performed on 169 patients by a single surgeon with assistance from senior surgical residents. All patients were offered local anesthesia using a cervical block technique with intraoperative supplementation. Patients for whom local anesthesia was inappropriate or who declined were operated on using general endotracheal anesthesia. Results of operation were tabulated including indication for operation, method of anesthesia, intraoperative and postoperative complications, and mortality, and completion of a patient satisfaction survey form either on postoperative visit or by telephone questionnaire.
Results: Of 169 patients who underwent carotid endarterectomy, 151 (89%) completed the satisfaction survey form. One hundred fourteen (62%) had local anesthesia and 71 patients (38%) had general anesthesia. There was 1 stroke (0.5%) and 1 death (0.5%) in the series. Perioperative complications including temporary cranial nerve injury, neck hematoma, myocardial infarction, and restenosis were noted and not significantly different in either the general anesthesia or local anesthesia group. Patient satisfaction data including intraoperative discomfort, postoperative pain, attentiveness of the operating room staff, and length of stay were all tabulated. There was no statistically significant difference in satisfaction between the general anesthesia group and the local anesthesia group (chi-square and Fisher’s exact test). Additionally, satisfaction with the procedure was extremely high.
Conclusions: Patient outcome and perception of pain and recovery were not statistically significantly different in patients undergoing carotid endarterectomy using local anesthesia compared with general anesthesia. Overall patient satisfaction was extremely high. Patients should be offered carotid endarterectomy using an anesthesia technique with which the surgeon and patients are both comfortable, having confidence that the outcome is not related to anesthesia technique and that patients will be highly satisfied.</description><subject>Aged</subject><subject>Anesthesia</subject><subject>Anesthesia, General - adverse effects</subject><subject>Anesthesia, General - psychology</subject><subject>Anesthesia, Local - adverse effects</subject><subject>Anesthesia, Local - methods</subject><subject>Anesthesia, Local - psychology</subject><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Asymptomatic</subject><subject>Biological and medical sciences</subject><subject>Carotid arteries</subject><subject>Cerebral infarction</subject><subject>Chi-Square Distribution</subject><subject>Choice Behavior</subject><subject>Complications</subject><subject>Coronary vessels</subject><subject>Cost analysis</subject><subject>Cranial nerves</subject><subject>Drugs</subject><subject>Endarterectomy, Carotid - adverse effects</subject><subject>Endarterectomy, Carotid - psychology</subject><subject>Female</subject><subject>General anesthesia</subject><subject>Heart surgery</subject><subject>Hematoma</subject><subject>Hospitals</subject><subject>Humans</subject><subject>Length of stay</subject><subject>Length of Stay - statistics & numerical data</subject><subject>Local anesthesia</subject><subject>Local anesthesia. Pain (treatment)</subject><subject>Male</subject><subject>Medical residencies</subject><subject>Medical sciences</subject><subject>Myocardial infarction</subject><subject>Pain</subject><subject>Pain perception</subject><subject>Pain, Postoperative - etiology</subject><subject>Patient Satisfaction</subject><subject>Postoperative</subject><subject>Practice Guidelines as Topic</subject><subject>Restenosis</subject><subject>Retrospective Studies</subject><subject>Statistical analysis</subject><subject>Stroke</subject><subject>Surgeons</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surveys</subject><subject>Surveys and Questionnaires</subject><subject>Time Factors</subject><subject>Treatment Outcome</subject><subject>Variables</subject><subject>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</subject><issn>0002-9610</issn><issn>1879-1883</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2000</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>8G5</sourceid><sourceid>BENPR</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNqFkVFr1TAUx4M4tuvcR5gEFHEP1ZwmbdMnGWNzwkBBfTUk6alm9DZ3STu4336n3osbvgiBkMMvJ__8DmOnIN6DgPrDNyFEWbQ1iHdCnAkhGyj0M7YC3bQFaC2fs9Vf5Ii9yPmWjgBKHrIjEK0USlcr9vOrnQKOE8-05976KcSR237CxL1NcQodx7GziQrop7je8jmH8Re3PONAlXCPfBOH4Lc89nyI3g7cjpin35iDfckOejtkPNnvx-zH1eX3i-vi5sunzxfnN4VXoKeiK0utoK1KV0vVi9ZZLJXTVSOc81Jh3bVYOnClK7W09H9pHdaNkp2rHADKY_Z213eT4t1Mr5t1yB6HgaLEOZsGGimh1QS-_ge8jXMaKZuhCI1Sra4VUdWO8inmnLA3mxTWNm0NCLPoN3_0m8WtEcsi_Wbp_mrffXZr7J7c2vkm4M0esJlM9cmOPuRHTjWa5kfYxx2G5Ow-YDLZ05Q8dmGZguli-E-SB1-LoU8</recordid><startdate>20000501</startdate><enddate>20000501</enddate><creator>Quigley, Terence M</creator><creator>Ryan, William R</creator><creator>Morgan, Shawn</creator><general>Elsevier Inc</general><general>Elsevier</general><general>Elsevier Limited</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>8G5</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>GUQSH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2O</scope><scope>MBDVC</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>Q9U</scope><scope>7X8</scope></search><sort><creationdate>20000501</creationdate><title>Patient satisfaction after carotid endarterectomy using a selective policy of local anesthesia</title><author>Quigley, Terence M ; Ryan, William R ; Morgan, Shawn</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c418t-d22841952b634f09bae24b8570bbc34e6d9e2b1b2b283a1013abe6743db5b11e3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2000</creationdate><topic>Aged</topic><topic>Anesthesia</topic><topic>Anesthesia, General - adverse effects</topic><topic>Anesthesia, General - psychology</topic><topic>Anesthesia, Local - adverse effects</topic><topic>Anesthesia, Local - methods</topic><topic>Anesthesia, Local - psychology</topic><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Asymptomatic</topic><topic>Biological and medical sciences</topic><topic>Carotid arteries</topic><topic>Cerebral infarction</topic><topic>Chi-Square Distribution</topic><topic>Choice Behavior</topic><topic>Complications</topic><topic>Coronary vessels</topic><topic>Cost analysis</topic><topic>Cranial nerves</topic><topic>Drugs</topic><topic>Endarterectomy, Carotid - adverse effects</topic><topic>Endarterectomy, Carotid - psychology</topic><topic>Female</topic><topic>General anesthesia</topic><topic>Heart surgery</topic><topic>Hematoma</topic><topic>Hospitals</topic><topic>Humans</topic><topic>Length of stay</topic><topic>Length of Stay - statistics & numerical data</topic><topic>Local anesthesia</topic><topic>Local anesthesia. Pain (treatment)</topic><topic>Male</topic><topic>Medical residencies</topic><topic>Medical sciences</topic><topic>Myocardial infarction</topic><topic>Pain</topic><topic>Pain perception</topic><topic>Pain, Postoperative - etiology</topic><topic>Patient Satisfaction</topic><topic>Postoperative</topic><topic>Practice Guidelines as Topic</topic><topic>Restenosis</topic><topic>Retrospective Studies</topic><topic>Statistical analysis</topic><topic>Stroke</topic><topic>Surgeons</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surveys</topic><topic>Surveys and Questionnaires</topic><topic>Time Factors</topic><topic>Treatment Outcome</topic><topic>Variables</topic><topic>Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Quigley, Terence M</creatorcontrib><creatorcontrib>Ryan, William R</creatorcontrib><creatorcontrib>Morgan, Shawn</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><jtitle>The American journal of surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Quigley, Terence M</au><au>Ryan, William R</au><au>Morgan, Shawn</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Patient satisfaction after carotid endarterectomy using a selective policy of local anesthesia</atitle><jtitle>The American journal of surgery</jtitle><addtitle>Am J Surg</addtitle><date>2000-05-01</date><risdate>2000</risdate><volume>179</volume><issue>5</issue><spage>382</spage><epage>385</epage><pages>382-385</pages><issn>0002-9610</issn><eissn>1879-1883</eissn><coden>AJSUAB</coden><abstract>Background: Patient satisfaction after carotid endarterectomy has not been specifically studied or reported. Results of carotid endarterectomy using either local or general anesthesia have been widely reported, and outcomes are not significantly different for either technique. Patient satisfaction data were obtained in order to determine whether patients preferred one method of anesthesia over another. Data regarding outcome may be added to the surgical literature as benchmark data when comparing operative carotid endarterectomy to newer techniques.
Methods: During a 30-month period, 186 consecutive carotid endarterectomies were performed on 169 patients by a single surgeon with assistance from senior surgical residents. All patients were offered local anesthesia using a cervical block technique with intraoperative supplementation. Patients for whom local anesthesia was inappropriate or who declined were operated on using general endotracheal anesthesia. Results of operation were tabulated including indication for operation, method of anesthesia, intraoperative and postoperative complications, and mortality, and completion of a patient satisfaction survey form either on postoperative visit or by telephone questionnaire.
Results: Of 169 patients who underwent carotid endarterectomy, 151 (89%) completed the satisfaction survey form. One hundred fourteen (62%) had local anesthesia and 71 patients (38%) had general anesthesia. There was 1 stroke (0.5%) and 1 death (0.5%) in the series. Perioperative complications including temporary cranial nerve injury, neck hematoma, myocardial infarction, and restenosis were noted and not significantly different in either the general anesthesia or local anesthesia group. Patient satisfaction data including intraoperative discomfort, postoperative pain, attentiveness of the operating room staff, and length of stay were all tabulated. There was no statistically significant difference in satisfaction between the general anesthesia group and the local anesthesia group (chi-square and Fisher’s exact test). Additionally, satisfaction with the procedure was extremely high.
Conclusions: Patient outcome and perception of pain and recovery were not statistically significantly different in patients undergoing carotid endarterectomy using local anesthesia compared with general anesthesia. Overall patient satisfaction was extremely high. Patients should be offered carotid endarterectomy using an anesthesia technique with which the surgeon and patients are both comfortable, having confidence that the outcome is not related to anesthesia technique and that patients will be highly satisfied.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>10930485</pmid><doi>10.1016/S0002-9610(00)00371-8</doi><tpages>4</tpages></addata></record> |
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| subjects | Aged Anesthesia Anesthesia, General - adverse effects Anesthesia, General - psychology Anesthesia, Local - adverse effects Anesthesia, Local - methods Anesthesia, Local - psychology Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Asymptomatic Biological and medical sciences Carotid arteries Cerebral infarction Chi-Square Distribution Choice Behavior Complications Coronary vessels Cost analysis Cranial nerves Drugs Endarterectomy, Carotid - adverse effects Endarterectomy, Carotid - psychology Female General anesthesia Heart surgery Hematoma Hospitals Humans Length of stay Length of Stay - statistics & numerical data Local anesthesia Local anesthesia. Pain (treatment) Male Medical residencies Medical sciences Myocardial infarction Pain Pain perception Pain, Postoperative - etiology Patient Satisfaction Postoperative Practice Guidelines as Topic Restenosis Retrospective Studies Statistical analysis Stroke Surgeons Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surveys Surveys and Questionnaires Time Factors Treatment Outcome Variables Vascular surgery: aorta, extremities, vena cava. Surgery of the lymphatic vessels |
| title | Patient satisfaction after carotid endarterectomy using a selective policy of local anesthesia |
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