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Effect of Preoperative Anesthesia Counseling on Patient’s Recovery after Surgery under General Anesthesia

Dr. G.N. Chavan, Professor and Head, Dept. of Anesthesiology, Chirayu Medical College & Hospital, Bhopal, Madhya Pradesh 462030, India. , Akanksha Agarwal1 , P.K. Bhattacharya2 , G.N. Chavan3

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Indian Journal of Anesthesia and Analgesia 5(1):p 110-114, January-February 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5118.17

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Abstract

Preoperative anesthesia assessment visit (PAC) can be used as a golden opportunity for counseling of the patient posted for elective surgery, its effects are time-tested on better perioperative recovery. Aims: To assess anxiety level and its effects in perioperative period in patients undergoing surgeries under General Anesthesia, secondly to assess postoperative recovery status with respect to cooperation, sedative and analgesic requirement, and finally to assess effect of counseling on final postoperative recovery status. Settings and Design: PAC clinic of Chirayu Medical College and Hopital. Methods and Material: Sixty ASA grade 1/2 patients, age group 18-60 years, were randomized to 2 groups: study group receiving detailed anesthesia and surgery counseling during preanesthesia check-up (PAC) one day prior and on the day of surgery. Control group undergo through conventional method of counseling one day prior to surgery. Study group will be given verbal and written advice on anaesthetic and medical risk as part of the informed consent for anesthesia. Protocol of anesthesia will be same in both the groups. Both groups were given APAIS questionnaire at time of PAC, reassessed in immediate preoperative period. VAS along with vital parameters were recorded at PAC time and again in immediate preoperative period, and then in immediately post extubation and then after every 15 mins till 2hrs in recovery room. Patient’s anxiety in postoperative period was assessed with APAIS after 12 & 24 hrs. Modified Aldrete Score was used to assess overall recovery of patients. Statistical analysis used: Statistical analysis was done using ‘unpaired t test’ with p value<0.005 as significant, after calculating standard deviation (SD) and mean value of different parameters. Results: The level of anxiety was significantly low in study group as compared to control group in immediate preoperative as well as postoperative periods at various time intervals, as assessed by APAIS & VAS, though both scores were lower in both groups in postoperative periods as compared to PAC time. In both groups, difference in vital parameters, that is, pulse rate, blood pressue, SpO2, was insignificant, at various time durations, although the decrease in pulse rate from the time of PAC to postoperative period was more in study group. Aldrete score of 10 (out of 10) was achieved earlier in study group (p statistically significant) than in control group. Conclusions: This study shows that a proper elaborative verbal and written counseling at time of preanesthesia check up can alleviate patients’ anxiety or stress, resulting in decreased morbidity and better outcome.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5118.17

Keywords

Preoperative Anesthesia Counselling; GA; Outcome; PAC. 

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