scholarly journals Virtual Reality for PEripheral Regional Anesthesia (VR-PERLA Study)

2020 ◽  
Vol 9 (1) ◽  
pp. 215 ◽  
Author(s):  
Camille Alaterre ◽  
Baptiste Duceau ◽  
Eileen Sung Tsai ◽  
Siham Zriouel ◽  
Francis Bonnet ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Patient Satisfaction ◽  
Regional Anesthesia ◽  
Standard Care ◽  
Satisfaction Score ◽  
Anxiety Reduction ◽  
Care Group ◽  
Hemodynamic Changes ◽  
Upper Limb Surgery ◽  
Patient Reported

When used as an add-on to regional anesthesia, virtual reality (VR) has been reported to provide anxiety-reducing benefits and sedation-sparing effects. However, its impact on patient satisfaction is still a matter of controversy. We investigated the feasibility and benefits of implementing intraoperative VR distraction in a French University Hospital (Hôpital Saint-Antoine, AP-HP). This monocentric observational before–after study included 100 patients who underwent ambulatory upper limb surgery under peripheral nerve block in January 2019, 50 before and 50 after implementation of an intraoperative VR distraction protocol. Primary outcome was patient self-rated satisfaction score evaluated right after surgery. Secondary outcomes included 2-month patient-reported satisfaction score, perioperative self-rated anxiety and intraoperative hemodynamic changes. Compared to former standard care, VR distraction was associated with significantly higher postoperative satisfaction scores (10 [IQR 9; 10] vs. 9 [8; 10], p < 0.001) still reported two months after surgery (10 [10;10] vs. 10 [8.5;10], p = 0.06). Patient median intraoperative anxiety score was lower in the VR group, compared to Standard Care group (0 [0; 2] vs. 3 [0.25; 7], p < 0.001), and occurrence of intraoperative hemodynamic changes was also lessened in the VR group (2% vs. 16%, 0R = 0.11[95% CI 0.002–0.87], p = 0.031). The present findings suggest that VR distraction program in the operating room could effectively improve patient satisfaction with anxiety-reduction and hemodynamic benefits.

scholarly journals Dexmedetomidine as an Adjuvant to Lignocaine for Intravenous Regional Anesthesia for Forearm and Hand Surgeries: A Prospective, Randomized, Controlled Study

2021 ◽  
Author(s):  
Moumita Roychowdhury ◽  
Anjum Naz
Keyword(s):  
Patient Satisfaction ◽  
Regional Anesthesia ◽  
Rating Scale ◽  
Controlled Study ◽  
Tourniquet Pain ◽  
Intravenous Regional Anesthesia ◽  
Upper Limb Surgery ◽  
Fentanyl Consumption ◽  
Group B ◽  
Preservative Free

Objective: Intravenous regional anesthesia (IVRA) is an effective anesthetic technique for surgical procedures of short duration involving the distal parts of the limbs. Intraoperative tourniquet pain is the major restraint of this technique, and to overcome this limitation, various adjuvants to local anesthetics have been used. This study investigated the effect of a fixed low dose of dexmedetomidine as an adjuvant to lignocaine on intraoperative tourniquet pain, onset of block, duration of block, and patient satisfaction. Methods: A total of 100 adult patients with ASA grade I and II who were scheduled for upper limb surgery of approximately 1 hour in duration were randomly divided into two groups (n=50 in each group). Group A received 35 mL of preservative-free lignocaine alone and Group B received 35 mL of preservative-free lignocaine along with 30 μg of dexmedetomidine. The incidence of tourniquet pain, intraoperative fentanyl consumption, duration of onset and recovery of sensory and motor block after tourniquet deflation, postoperative numeric pain rating scale (NPRS) scores, duration of analgesia, and overall patient satisfaction were noted. Result: The incidence of tourniquet pain and intraoperative fentanyl consumption were significantly lower in Group B. The onset and duration of sensory and motor blocks were faster and longer, respectively, in Group B. Postoperative NPRS scores were lower, duration of analgesia was longer, and overall patient satisfaction was better in the dexmedetomidine group. Conclusion: Dexmedetomidine at a dose of 30 μg as a lignocaine adjuvant significantly reduces tourniquet pain and intraoperative fentanyl consumption in IVRA. Dexmedetomidine shortens the onset of block, prolongs the duration of block, and provides a more satisfactory anesthesia than lignocaine alone.

Evaluation of Long-term Outcomes Following Plantar Fasciotomy

2018 ◽  
Vol 39 (11) ◽  
pp. 1312-1319 ◽  
Author(s):  
Rebekah Gibbons ◽  
Katherine E. Mackie ◽  
Todd Beveridge ◽  
Dana Hince ◽  
Peter Ammon
Keyword(s):  
Patient Satisfaction ◽  
Plantar Fasciitis ◽  
Satisfaction Score ◽  
Satisfaction Survey ◽  
Long Term Outcomes ◽  
Short Term ◽  
Patient Reported ◽  
Plantar Fasciotomy

Background: Plantar fasciitis is a common condition prevalent in both athletic and nonathletic populations. Approximately 10% of patients do not respond to conservative treatment and suffer chronic recalcitrant plantar fasciitis. Outcomes following plantar fasciotomy vary but short-term studies have reported excellent early pain relief and return to activity, and significant improvements in symptoms. Previous study limitations include small patient cohorts, short-term duration of follow-up or lack of validated outcome measures. We therefore aimed to investigate the long-term outcomes following complete plantar fasciotomy. Methods: Patients who underwent complete plantar fasciotomy surgery from a single surgeon within the past 10 years (minimum 7 months) were invited to participate in this retrospective survey study. To evaluate patient-reported function, participants were asked to complete the Foot and Ankle Outcome Score (FAOS). To assess subjective outcome, the participants were provided a satisfaction survey. The satisfaction survey was designed to include the 3 key factors for assessing postoperative patient satisfaction, which are preoperative expectations, symptom relief, and hospital experience. A total of 74 questionnaires were returned. Results: The median global satisfaction score was 85.4 (IQR=37.5) points out of 100. Significant correlations between the global patient satisfaction score and all FAOS subscale scores were identified. Only 3 participants (4%) reported a complication following surgery; however, 32 participants (44.4%) indicated that they still experienced swelling and/or tenderness in their foot at the time of the survey (mean follow-up time 4.8 ± 2.8 years) but for the majority of patients this was improved from before surgery. Conclusion: Long-term patient satisfaction was experienced by the majority of patients following plantar fasciotomy. Although 44% of patients continue to have postoperative complaints, 73% indicated that they were satisfied with their symptoms postoperatively, and 74% would undergo a similar procedure again. Level of Evidence: Level IV, case series.

Role of Telemedicine in Inflammatory Bowel Disease: a Systematic Review and Meta-analysis of Randomized Clinical Trials (Preprint)

2021 ◽  
Author(s):  
Lanlan Pang ◽  
Heng-Yu Liu ◽  
Zhidong Liu ◽  
Jingyu Tan ◽  
Loungyuan Zhou ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Patient Satisfaction ◽  
Medication Adherence ◽  
Standard Care ◽  
Remission Rate ◽  
Meta Analysis ◽  
Care Group ◽  
Standard Care Group ◽  
Inflammatory Bowel ◽  
Clinic Visits

BACKGROUND Telemedicine plays an important role in the management of patients with inflammatory bowel disease (IBD), which is especially evident during the pandemic such as COVID-19. However, the exact effectiveness and efficiency of telemedicine in managing IBD is unclear. OBJECTIVE We aimed to compare the impact of telemedicine on management of IBD patients with the standard care. METHODS We systematically searched the PubMed, Cochrane Library, EMBASE, Web of Science, and Scopus (search date April 22, 2020). Randomized controlled trials (RCTs) comparing telemedicine with standard care in IBD patients were included, while conference abstracts, letters, reviews, laboratory studies, or case reports were excluded. The IBD-specific quality of life (QoL), disease activity and remission rate of IBD patients were assessed as primary outcomes, and the number of clinic visits per patient, patient satisfaction, psychological outcome, and medication adherence were regarded as secondary outcomes. The Review Manage 5.3 and Stata 15.1 were used for the data analysis. RESULTS 17 RCTs (n=2571 participants) were included in this meta-analysis. The telemedicine group had higher IBD-specific QoL than the standard care group [standard mean difference (SMD) 0.18, 95% confidence interval (CI) 0.01 to 0.34，P=0.03)]. Furthermore, the number of clinic visits per patient in the telemedicine group was significantly lower than that in the standard care group (SMD -0.71, 95%CI -1.07 to -0.36, P<0.0001). Subgroup analysis showed that adolescents had a significantly higher IBD-specific QoL in telemedicine group than that in standard care group (SMD 0.42, 95%CI 0.15 to 0.69, I2=0%, P=0.002), while there was no significant differences between two groups among adults. There were no significant differences in disease activity, remission rate, patient satisfaction, depression, self-efficacy, generic QoL, and medication adherence outcomes between telemedicine and standard care group. CONCLUSIONS Telemedicine intervention showed a promising role in improving IBD-specific QoL among adolescents and decreased the number of clinic visits of IBD patients. Further researches are warranted to identify the ideal group of IBD patients who could benefit from telemedicine most.

scholarly journals Patient Satisfaction versus Patient Reported Outcomes

2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0014
Author(s):  
Chayanin Angthong
Keyword(s):  
Patient Satisfaction ◽  
Patient Reported Outcomes ◽  
Satisfaction Score ◽  
Successful Outcome ◽  
P Value ◽  
Treatment Level ◽  
Foot And Ankle ◽  
Patient Satisfaction Score ◽  
Sf 36 ◽  
Patient Reported

Category: Other Introduction/Purpose: Several researches focused on patient reported outcomes (PROs), however, little is known about the actual correlation between the patient satisfaction and PROs. The present study is to determine the correlation between patient satisfaction and PROs. Methods: A total of 35 patients with foot and ankle disability participated in this study to complete the data in terms of the patient satisfaction score and PROs. All of them were treated by a single foot and ankle surgeon. The Thai patient satisfaction score or Foot and Ankle Satisfaction Score [FASS] (0 [worst] -100 [best]) consisted of 4 items regarding patient’s perspectives as 1) symptoms, 2) function, 3) other complaints, and 4) recommendation of his/her treatment for other patients. PROs measures consisted of validated Thai visual analogue scale foot and ankle (VASFA) (0 [worst] -100 [best]) and Thai Short Form-36 (SF-36) (0 [worst] -100 [best]). Results: Mean total FASS was 92.0 ± 11.8, 87.7 ± 17.0, 98.6 ± 6.0, 98.6 ± 8.5 and for the items: symptoms, function, other complaints, and recommendation of his/her treatment for other patients, respectively. Mean total FASS was 94.2 ± 6.8. Mean VASFA was 67.7 ± 18.3. Mean SF-36 was 82.7 ± 10.7.There were no significant correlations between mean total FASS and PROs (VASFA [p-value < 0.05], SF-36 [p-value <0.05]). There were no significant correlations between mean FASS in all items and PROs (VASFA, SF-36) with all p-values < 0.05. The significant correlation was found between VASFA and SF-36 (Pearson correlation coefficient = 0.734; p-value<0.01). Conclusion: One of the successful treatment results is the improvement of patient satisfaction. Even if several researches focused on the assessment of PROs to achieve the successful outcome, this kind of measures was no significant correlation with patient satisfaction. PROs were not able to reflect the patient satisfaction following treatments. Patient satisfaction may be related to other parameters, in addition to the PROs, such as the patient expectation, the post-treatment level of physician-patient relationship, the patient’s confidence in his/her physician capability, etc. Further study is needed to clarify these factors.

Virtual Reality for Hypertension in Tooth Extraction: A Randomized Trial

2021 ◽  
pp. 002203452110493
Author(s):  
Z. Qin ◽  
C. Zhou ◽  
Y. Zhu ◽  
Y. Wang ◽  
H. Cao ◽  
...  
Keyword(s):  
Virtual Reality ◽  
Standard Care ◽  
Tooth Extraction ◽  
Dental Anxiety ◽  
Care Group ◽  
Clinical Trial Registry ◽  
Anxiety Management ◽  
Intention To Treat ◽  
The Difference ◽  
And Gender

Tooth extraction is one of the most common causes of dental anxiety and pain, leading to the elevation of blood pressure (BP) and heart rate (HR). Such effects may be exaggerated and cause life-threatening accidents in patients with hypertension. Therefore, the pain and anxiety management of these patients is imperative. Virtual reality (VR) has been demonstrated to be a distraction method to relieve anxiety and pain in clinical operations. Thus, we hypothesized that VR can control the elevation of BP and HR in patients with hypertension. In this study, 96 eligible patients with controlled hypertension who needed tooth extraction were randomized to the VR or standard care group by stratified randomization of anxiety grade and gender. Their BP and HR were dynamically monitored. The corresponding systolic and diastolic BP and HR values were selected when systolic BP was at the highest point of the process. BP was converted into mean arterial pressure (MAP) for comparison per the following formula: MAP = (systolic BP + 2 × diastolic BP)/3. Statistical analyses were by intention to treat and conducted in SPSS. Nonparametric rank sum tests were used to compare the difference of ΔMAP and ΔHR between the VR and standard care groups. Multivariate linear regression was applied to evaluate the effect of VR on ΔMAP and ΔHR. The results showed that the VR technique significantly decreased the elevation of MAP ( P < 0.001) and HR ( P < 0.001), and this effect was found even after adjusting for baseline characteristics and additional surgical procedures (ΔMAP, P < 0.001, R2 = 0.276; ΔHR, P < 0.001, R2 = 0.152). VR did not increase the incidence of adverse events ( P = 0.677). In conclusion, the VR technique was effective in controlling BP and HR within an acceptable range and can help manage BP and HR during tooth extraction for patients with hypertension (Chinese Clinical Trial Registry: ChiCTR2100042132).

scholarly journals Preoperative and intraoperative factors contributing to patient satisfaction after bi-cruciate stabilized total knee arthroplasty

2021 ◽  
Vol 29 (3) ◽  
pp. 230949902110340
Author(s):  
Hiroshi Inui ◽  
Shuji Taketomi ◽  
Ryota Yamagami ◽  
Kenichi Kono ◽  
Kohei Kawaguchi ◽  
...  
Keyword(s):  
Total Knee Arthroplasty ◽  
Regression Analysis ◽  
Patient Satisfaction ◽  
Knee Arthroplasty ◽  
Multivariate Regression ◽  
Multivariate Regression Analysis ◽  
Joint Laxity ◽  
Satisfaction Score ◽  
Patient Reported ◽  
Total Knee

Background: One of the causes of dissatisfaction following total knee arthroplasty (TKA) is abnormal knee kinematics. A newly designed bi-cruciate stabilized (BCS) TKA system has been developed to produce close-to-normal kinematics because of its anatomic tibiofemoral articular geometry and cam-post mechanism. Although BCS TKA is expected to improve patient satisfaction, no reports have described the appropriate technique or soft tissue handling required to achieve excellent satisfaction with BCS TKA. This study is to identify preoperative and intraoperative predictors of patient satisfaction after BCS TKA. Methods: Altogether, we studied 113 knees with primary varus knee osteoarthritis that underwent BCS TKA with a navigation system. Preoperative parameters including Knee Society Score and patient-reported scores [the Knee injury and Osteoarthritis Outcome Score (KOOS)] and intraoperative parameters including coronal, sagittal and axial alignment and joint laxity in each compartment that affected patient satisfaction was evaluated. Satisfaction score was evaluated with use of the 2011 Knee Society Scoring system. The multivariate regression analysis included age and preoperative and intraoperative parameters that correlated with satisfaction scores in the univariate analysis ( P < 0.05). Results: The mean satisfaction score was 28.2 ± 6.1. Multivariate regression analysis showed that the predictors of patient satisfaction were a preoperative high KOOS score for activities of daily living ( P < 0.001), male sex ( P = 0.005), older age ( P = 0.027), and minimal medial joint laxity during flexion ( P = 0.031). Conclusion: When performing BCS TKA, surgeons should pay attention to maintaining proper stability of the medial compartment, especially during flexion.

scholarly journals One-year intensive lifestyle intervention and improvements in health-related quality of life and mental health in persons with type 2 diabetes: a secondary analysis of the U-TURN randomized controlled trial

2021 ◽  
Vol 9 (1) ◽  
pp. e001840
Author(s):  
Christopher Scott MacDonald ◽  
Sabrina M Nielsen ◽  
Jakob Bjørner ◽  
Mette Y Johansen ◽  
Robin Christensen ◽  
...  
Keyword(s):  
Lifestyle Intervention ◽  
Standard Care ◽  
Controlled Trial ◽  
Care Group ◽  
Standard Care Group ◽  
Intensive Lifestyle Intervention ◽  
Sf 36 ◽  
Related Quality ◽  
Health Related

IntroductionThe effects of lifestyle interventions in persons with type 2 diabetes (T2D) on health-related quality of life (HRQoL) and subjective well-being are ambiguous, and no studies have explored the effect of exercise interventions that meet or exceed current recommended exercise levels. We investigated whether a 1-year intensive lifestyle intervention is superior in improving HRQoL compared with standard care in T2D persons.Research design and methodsWe performed secondary analyses of a previously conducted randomized controlled trial (April 2015 to August 2016). Persons with non-insulin-dependent T2D (duration ≤10 years) were randomized to 1-year supervised exercise and individualized dietary counseling (ie, ‘U-TURN’), or standard care. The primary HRQoL outcome was change in the 36-item Short Form Health Survey (SF-36) physical component score (PCS) from baseline to 12 months of follow-up, and a key secondary outcome was changes in the SF-36 mental component score (MCS).ResultsWe included 98 participants (U-TURN group=64, standard care group=34) with a mean age of 54.6 years (SD 8.9). Between-group analyses at 12-month follow-up showed SF-36 PCS change of 0.8 (95% CI −0.7 to 2.3) in the U-TURN group and deterioration of 2.4 (95% CI −4.6 to −0.1) in the standard care group (difference of 3.2, 95% CI 0.5 to 5.9, p=0.02) while no changes were detected in SF-36 MCS. At 12 months, 19 participants (30%) in the U-TURN group and 6 participants (18%) in the standard care group achieved clinically significant improvement in SF-36 PCS score (adjusted risk ratio 2.6, 95% CI 1.0 to 4.5 corresponding to number needed to treat of 4, 95% CI 1.6 to infinite).ConclusionIn persons with T2D diagnosed for less than 10 years, intensive lifestyle intervention improved the physical component of HRQoL, but not the mental component of HRQoL after 1 year, compared with standard care.Trial registration numberNCT02417012.

Patient Satisfaction and Short-Term Outcome in Elective Cranial Neurosurgery

Neurosurgery ◽  
2015 ◽  
Vol 77 (5) ◽  
pp. 769-776 ◽  
Author(s):  
Elina Reponen ◽  
Hanna Tuominen ◽  
Juha Hernesniemi ◽  
Miikka Korja
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Health Status ◽  
Patient Experience ◽  
University Hospital ◽  
Term Outcome ◽  
Major Morbidity ◽  
Patient Reported ◽  
Relationship Of

Abstract BACKGROUND: Patient-reported experience is often used as a measure for quality of care, but no reports on patient satisfaction after cranial neurosurgery exist. OBJECTIVE: To study the association of overall patient satisfaction and surgical outcome and to evaluate the applicability of overall patient satisfaction as a proxy for quality of care in elective cranial neurosurgery. METHODS: We conducted an observational study on the relationship of overall patient satisfaction at 30 postoperative days with surgical and functional outcome (modified Rankin Scale [mRS] score) in a prospective, consecutive, and unselected cohort of 418 adult elective craniotomy patients enrolled between December 2011 and December 2012 at Helsinki University Hospital, Helsinki, Finland. RESULTS: Postoperative overall (subjective and objective) morbidity was present in 194 (46.4%) patients; yet almost 94% of all study patients reported high overall satisfaction. Low overall patient satisfaction at 30 days was not associated with postoperative major morbidity in elective cranial neurosurgery. Dependent functional status (mRS score ≥3) at 30 days, minor infections, poor postoperative subjective overall health status, and patient-reported severe symptoms (double vision, poor balance) may contribute to unsatisfactory patient experience. CONCLUSION: Overall patient satisfaction with elective cranial neurosurgery is high. Even 9 of 10 patients with postoperative major morbidity rated high overall patient satisfaction at 30 days. Overall patient satisfaction may merely reflect patient experience and subjective postoperative health status, and therefore it is a poor proxy for quality of care in elective cranial neurosurgery.

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