Aanesthetic Agents for Day Surgery - NIHR Health Technology ...

TABLE 76 Reason given for preference for maintenance
method in the paediatric study
Reason given No. of parents/guardians
Propofol/ Sevoflurane/
halothane sevoflurane
(n = 132) (n = 128)
Less chance of being sick 112 (85%) 109 (85%)
It is distressing being sick 4 (3%) 6 (5%)
Sickness does not last as long 2 (2%) 1 (0.5%)
Son/daughter was sick
this time
1 (0.5%) 0 (0%)
feeling or being sick was quantified using willingness
to pay (see chapter 5). Some respondents (4%
propofol/halothane; 5% sevoflurane/sevoflurane)
did not understand the question and only used the
values offered on the VAS, and one respondent
stated a protest value of £0. These values were
excluded from the analysis in the empirical study.
Table 77 summarises the parents’ or guardians’
reasons for preferring maintenance with medicine
D. The majority of parents’ or guardians’ stated
willingness-to-pay value reflected how much they
valued their child not being sick. Interestingly,
some respondents felt that avoiding sickness was
not as important as the choice between an injection
or mask for the induction of anaesthesia.
Adult patients’ views
A total of 85% (n = 907) of patients recruited
into the empirical study were telephoned. Of
these, 25% (n = 228) had received propofol induction
and maintenance anaesthesia (propofol/
propofol), 26% (n = 232) had received propofol
induction and isoflurane maintenance anaesthesia
(propofol/isoflurane), 26% (n = 234) had received
propofol induction and sevoflurane maintenance
anaesthesia (propofol/sevoflurane) and 23%
TABLE 77 Reason given for willingness to pay for maintenance method in the paediatric study
© Queen’s Printer and Controller of HMSO 2002. All rights reserved.
Health Technology Assessment 2002; Vol. 6: No. 30
(n = 213) had received sevoflurane induction
and maintenance anaesthesia (sevoflurane/
sevoflurane).
Which anaesthetic did I have?
The majority (85% propofol/propofol, 87%
propofol/isoflurane, 89% propofol/sevoflurane,
89% sevoflurane/sevoflurane) of patients correctly
recalled the type of induction anaesthetic they
were given.
All patients in the empirical study would probably
have received oxygen via a mask and had a cannula
put in place prior to induction for safety reasons.
This could explain the confusion by some patients
who believed they had an injection and a mask
when sent to sleep or mistakenly thought they were
given an injection when they had a mask, or vice
versa (3% propofol/propofol, 7% propofol/
isoflurane, 5% propofol/sevoflurane, 4%
sevoflurane/sevoflurane).
A minority (5% propofol/propofol, 1% propofol/
isoflurane, 3% propofol/sevoflurane, 1%
sevoflurane/sevoflurane) of patients were not
sure which type of induction agent they had,
and they said:
“I went to sleep too quickly to remember”.
Views on this anaesthetic
Table 78 summarises the patients’ views about
the anaesthetic received in the empirical study.
Respondents were offered a choice of three
possible answers to this question: pleasant,
unpleasant or average.
Discomfort from injection or mask
More patients who had propofol/propofol (29%)
said they experienced discomfort from the
injection than those who had propofol/isoflurane
(23%) or propofol/sevoflurane(19%). Of these
Reason given No. of parents/guardians
Propofol/halothane Sevoflurane/sevoflurane
(n = 132) (n = 128)
Less chance of being sick (willingness to avoid) 71 (54%) 76 (59%)
Only pay more if zero chance of being sick with medicine D 18 (26%) 14 (11%)
Want the best one for my son/daughter (willingness to accept) 16 (12%) 11 (9%)
Medicine C and D are similar 4 (3%) 7 (5%)
This is not as important as the choice of induction agent 6 (5%) 2 (2%)
Being sick will prolong recovery 3 (2%) 3 (2%)
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