12 de agosto de 2011

Artigo: Main Concerns of Patients Regarding the Most Common Complications in the Post-Anesthetic Care Unit



Eduardo Toshiyuki Moro, TSA, M.D., Renato César Senne Godoy, M.D., Alexandre Palmeira Goulart, M.D., Leopoldo Muniz, M.D., Norma Sueli Pinheiro Modolo, M.D.


Revista Brasileira de Anestesiologia
Vol. 59, No 6, Novembro-Dezembro, 2009

INTRODUCTION

Preoperative anxiety is frequently associated with anticipation of anesthesia- or surgery-related damages. Severe complications that can be attributed to anesthesia such as death are rare. On the other hand, “minor” events such as pain, nausea, or vomiting have assumed a fundamental role in the determination of the quality provided by the Anesthesiology service1.

When postoperative fears are analyzed regarding low morbidity events that should be avoided the most, anesthesiologists have not always been capable to determine the priorities of the patients2. Thus, successful treatment of postoperative pain, for example, is not necessarily related with higher satisfaction with anesthesia, since the consequences of pain treatment, such as nausea and vomiting, should be considered.

In a study undertaken in the United States, Macario et al.3 evaluated the opinion of patients on the subject. Possible undesirable effects in the immediate postoperative period based on data from the literature (MEDLINE between 1986 and 1997) were listed. Since the list generated by this search was extensive, the authors decided to select the nine most frequent events, besides a tenth item described as “normal” (without any undesirable effects) to evaluate the reliability of the answers, since understanding of the questionnaire by the patients interviewed presupposed that the “normal” item would always be classified as “the least undesirable” or the “most desirable” (Chart I).

However, the study population was composed mainly by individuals with high socio-economical and cultural level, which might not represent the reality of health services in regions where social indicators usually show a higher inequality rate. The objectives of the present study included:
1) to evaluate the main concerns of patients regarding the post-anesthetic period and to compare them with those observed by Macario et al.3; and 
2) to test the hypothesis that the most undesirable effects, according to the opinion of the patients interviewed, could be influenced by demographic characteristics like educational level and family income.

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