Measurement of patient satisfaction as an outcome of regional anesthesia and analgesia: A systematic review

2001 ◽  
Vol 26 (3) ◽  
pp. 196-208 ◽  
Author(s):  
C Wu
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Regional Anesthesia

Wide-Awake Local Anesthesia No Tourniquet (WALANT) versus Local or Intravenous Regional Anesthesia with Tourniquet in Atraumatic Hand Cases in Orthopedics: A Systematic Review and Meta-Analysis

2019 ◽  
Vol 24 (04) ◽  
pp. 469-476 ◽  
Author(s):  
Ted Matthew P. Evangelista ◽  
John Hubert C. Pua ◽  
Mara Therese P. Evangelista-Huber
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Confidence Interval ◽  
Local Anesthesia ◽  
Regional Anesthesia ◽  
Random Effects ◽  
Complication Rates ◽  
Pain Scores ◽  
Intravenous Regional Anesthesia ◽  
Post Operative Pain

Background: To compare outcomes of atraumatic hand surgeries using the WALANT technique versus intravenous regional anesthesia or local anesthesia with tourniquet. Methods: We conducted a comprehensive literature search using PubMed, MEDLINE, Embase, and Cochrane Library from inception to October 2018. All randomized or quasi-randomized trials and cohort studies comparing WALANT procedure versus local anesthesia or intravenous regional anesthesia with tourniquet among atraumatic hand surgeries were included. Methodological quality and risk of bias of eligible studies were assessed by three independent reviewers. The random effects model was used due to both statistical and clinical heterogeneity among studies. Results: The search yielded 496 records, of which 9 studies were included in the systematic review. We were able to pool findings for operative time, post-operative pain scores, patient satisfaction, and complication rates. On the average, the WALANT group had longer operative times by 2.06 minutes (pooled mean difference, random effects, 95% confidence interval 0.46 to 3.67 minutes, p = 0.01, I2 0%, p = 0.66). The post-operative pain scores were lower in the WALANT group by an average of two VAS points (random effects, pooled mean difference −2.40, 95% confidence interval −3.41 to −1.38, p < 0.00001; I2 0% p = 0.99). We had insufficient evidence to demonstrate a difference in terms of patient satisfaction (random effects, pooled risk ratio 0.98, 95% confidence interval 0.93 to 1.03, p = 0.36, I2 0%, p = 0.64) and complication rates (random effects, pooled risk ratio 0.40, 95% confidence interval 0.07 to 2.18, p = 0.29, I2 60% p = 0.08) between WALANT versus conventional methods. Conclusions: The WALANT group reported lower post-operative pain scores, but had slightly longer operative times. There are no significant differences between WALANT and conventional methods in terms of patient satisfaction and complication rates.

scholarly journals Influence of Femoral Version on the Outcomes of Hip Arthroscopic Surgery for Femoroacetabular Impingement or Labral Tears: A Systematic Review and Meta-analysis

2021 ◽  
Vol 9 (6) ◽  
pp. 232596712110091
Author(s):  
Chenghui Wang ◽  
Yaying Sun ◽  
Zheci Ding ◽  
Jinrong Lin ◽  
Zhiwen Luo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Femoroacetabular Impingement ◽  
Arthroscopic Surgery ◽  
Harris Hip Score ◽  
Cochrane Library ◽  
Femoral Version ◽  
Labral Tears ◽  
Significant Difference ◽  
Secondary Outcomes

Background: It remains controversial whether abnormal femoral version (FV) affects the outcomes of hip arthroscopic surgery for femoroacetabular impingement (FAI) or labral tears. Purpose: To review the outcomes of hip arthroscopic surgery for FAI or labral tears in patients with normal versus abnormal FV. Study Design: Systematic review; Level of evidence, 4. Methods: Embase, PubMed, and the Cochrane Library were searched in July 2020 for studies reporting the outcomes after primary hip arthroscopic surgery for FAI or labral tears in patients with femoral retroversion (<5°), femoral anteversion (>20°), or normal FV (5°-20°). The primary outcome was the modified Harris Hip Score (mHHS), and secondary outcomes were the visual analog scale (VAS) for pain, Hip Outcome Score–Sport-Specific Subscale (HOS-SSS), Non-Arthritic Hip Score (NAHS), failure rate, and patient satisfaction. The difference in preoperative and postoperative scores (Δ) was also calculated when applicable. Results: Included in this review were 5 studies with 822 patients who underwent hip arthroscopic surgery for FAI or labral tears; there were 166 patients with retroversion, 512 patients with normal version, and 144 patients with anteversion. Patients with retroversion and normal version had similar postoperative mHHS scores (mean difference [MD], 2.42 [95% confidence interval (CI), –3.42 to 8.26]; P = .42) and ΔmHHS scores (MD, –0.70 [96% CI, –8.56 to 7.15]; P = .86). Likewise, the patients with anteversion and normal version had similar postoperative mHHS scores (MD, –3.09 [95% CI, –7.66 to 1.48]; P = .18) and ΔmHHS scores (MD, –1.92 [95% CI, –6.18 to 2.34]; P = .38). Regarding secondary outcomes, patients with retroversion and anteversion had similar ΔNAHS scores, ΔHOS-SSS scores, ΔVAS scores, patient satisfaction, and failure rates to those with normal version, although a significant difference was found between the patients with retroversion and normal version regarding postoperative NAHS scores (MD, 5.96 [95% CI, 1.66-10.26]; P = .007) and postoperative HOS-SSS scores (MD, 7.32 [95% CI, 0.19-14.44]; P = .04). Conclusion: The results of this review indicated that abnormal FV did not significantly influence outcomes after hip arthroscopic surgery for FAI or labral tears.

Development and Validation of the Questionnaire of Satisfaction with Perioperative Anesthetic Care for General and Regional Anesthesia in Taiwanese Patients

2011 ◽  
Vol 114 (5) ◽  
pp. 1064-1075 ◽  
Author(s):  
Wui-Chiu Mui ◽  
Chia-Ming Chang ◽  
Kong-Fah Cheng ◽  
Tak-Yu Lee ◽  
Kwok-On Ng ◽  
...  
Keyword(s):  
Factor Analysis ◽  
Patient Satisfaction ◽  
Regional Anesthesia ◽  
Anesthetic Care ◽  
Anesthesia Group ◽  
Confounding Variables ◽  
Group 3 ◽  
Group 2 ◽  
Nomological Validity ◽  
Group 1

Background To fulfill the increasing demand of service quality improvement in recent years, it is imperative to develop a proper instrument to evaluate patient satisfaction with perioperative anesthetic care for many institutes in Taiwan. Methods We used a six-factor 32-item pilot questionnaire developed in our previous study as our starting point in this study. Exploratory factor analysis of the pilot questionnaire for factor structure generation was performed in general anesthesia patients (group 1, n = 320) and resulted in the generation of the Patient Satisfaction with Perioperative Anesthetic Care questionnaire (PSPACq). Confirmatory factor analysis of the PSPACq in general anesthesia (group 2, n = 565) and regional anesthesia (group 3, n = 225) patients was performed for validation and cross-validation of the PSPACq model, respectively. The confounding variables and the patient loyalty effects on PSPACq scores were analyzed to evaluate the nomological validity of the PSPACq. Result Exploratory factor analysis of the pilot questionnaire in group 1 resulted in the development of the PSPACq (a seven-factor 30-item model). The standardized coefficients and indexes for the assessment of fit of the PSPACq model in group 2 (validation) and group 3 (cross-validation) patients revealed a well-fitting model. The results of the loyalty scores and confounding variables support the nomological validity of the PSPACq. Conclusions A valid and reliable questionnaire (PSPACq) with Taiwanese culture characteristics was developed and is suitable for testing of patient satisfaction with perioperative anesthesia care for patients receiving general or regional anesthesia for their surgery.

Telemedicine in paediatric emergency care: A systematic review

2021 ◽  
pp. 1357633X2110101
Author(s):  
Aditi Mitra ◽  
Rubina Veerakone ◽  
Kathleen Li ◽  
Tyler Nix ◽  
Andrew Hashikawa ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Emergency Care ◽  
Cost Savings ◽  
Process Measures ◽  
Paediatric Emergency ◽  
Paediatric Emergency Care ◽  
Therapeutic Decision Making ◽  
The Impact

Introduction The impact of telemedicine on the access and quality of paediatric emergency care remains largely unexplored because most studies to date are focused on adult emergency care. We performed a systematic review of the literature to determine if telemedicine is effective in improving quality of paediatric emergency care with regards to access, process measures of care, appropriate disposition, patient-centred outcomes and cost-related outcomes. Methods We developed a systematic review protocol in accordance with PRISMA (Preferred Reporting Items for Systematic Review) guidelines. We included studies that evaluated the impact of synchronous and asynchronous forms of telemedicine on patient outcomes and process measures in the paediatric emergency care setting. Inclusion criteria were study setting, study design, intervention type, age, outcome measures, publication year and language. Results Overall, 1.9% (28/1434) studies met study inclusion and exclusion criteria. These studies revealed that telemedicine increased accuracy of patient assessment in the pre-clinical setting, improved time-to disposition, guided referring emergency department (ED) physicians in performing appropriate life-saving procedures and led to cost savings when compared to regular care. Studies focused on telepsychiatry demonstrated decreased length of stay (LOS), transfer rates and improved patient satisfaction scores. Discussion Our comprehensive review revealed that telemedicine enhances paediatric emergency care, enhances therapeutic decision-making and improves diagnostic accuracy, and reduces costs. Specifically, telemedicine has its most significant impact on LOS, access to specialized care, cost savings and patient satisfaction. However, there was a relative lack of randomized control trials, and more studies are needed to substantiate its impact on morbidity and mortality.

scholarly journals Patient Satisfaction After Total Knee Replacement: A Systematic Review

2018 ◽  
Vol 14 (2) ◽  
pp. 192-201 ◽  
Author(s):  
Cynthia A. Kahlenberg ◽  
Benedict U. Nwachukwu ◽  
Alexander S. McLawhorn ◽  
Michael B. Cross ◽  
Charles N. Cornell ◽  
...  
Keyword(s):  
Systematic Review ◽  
Patient Satisfaction ◽  
Total Knee Replacement ◽  
Knee Replacement ◽  
Total Knee
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