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

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Appendix 16
TABLE 78 Views on the anaesthetic received in the adult empirical study
View on No. of patients
anaesthetic
Propofol/propofol Propofol/isoflurane Propofol/sevoflurane Sevoflurane/sevoflurane
(n = 228) (n = 232) (n = 234) (n = 213)
Pleasant 149 (65%) 160 (69%) 166 (71%) 120 (57%)
Unpleasant 23 (10%) 14 (6%) 17 (7%) 45 (21%)
Average 41 (18%) 47 (20%) 40 (17%) 39 (18%)
Not sure 15 (7%) 11 (5%) 11 (5%) 9 (4%)
patients, some referred to the experience of the
propofol being administered. They reported
slightly different feelings:
“I could feel the cold going up arm, very
uncomfortable” [agyfs105]
“... hot warm sensation at time of injection, site still
sore and swollen” [agyfa544].
Some patients referred to the discomfort
associated with the cannula being put in place:
“They couldn’t find a vein and it was painful to get
needle in” [agnfc069].
Around 1 in 5 patients said they experienced some
discomfort with the mask (17% sevoflurane/
sevoflurane). Some of these patients referred to
the smell or taste of the sevoflurane:
“No physical problems but I didn’t like the smell and
I could still smell and taste it next day” [agyfa764]
and some did not like the feeling of the mask
being held down on their face:
“The anaesthetist held the mask down and I didn’t
like it” [agyfa150].
Anaesthetic comparisons
The majority of patients (86% propofol/
propofol, 82% propofol/isoflurane, 87%
propofol/ sevoflurane, 85% sevoflurane/
sevoflurane) had experienced a previous
operation. These patients had undergone a
wide variety of different procedures, from day
procedures to hip replacement, spinal surgery
and mastectomy.
Table 79 summarises the comparisons patients
made with the anaesthetic they had in this study
and previous anaesthetics experienced. Some
patients may have mentioned more than one
theme in their comparison.
Generally, the patients were clear which
anaesthetic they preferred. However, some
patients, especially those who were randomised to
receive sevoflurane/sevoflurane, reported both
positive and negative experiences:
“Going to sleep was better, no sharp sting in my hand,
but I was sick afterwards” [agnmc120]
“I preferred the mask to go to sleep – I don’t like the
drunk feeling with the injection. I did feel really sick
and had a severe headache though” [agyfa817].
Ready to leave hospital
The majority of patients (88% propofol/propofol,
85% propofol/isoflurane, 85% propofol/
sevoflurane, 88% sevoflurane/sevoflurane) felt
ready to go home when they did, as this one
explained:
”Yes, if I’d stayed an extra night I wouldn’t have been
any better” [agnmc196].
Some of the patients wanted to get home to their
own environment, even though they may not have
been feeling very well:
“I felt I wanted to go home, but felt poorly. It was my
decision to go home” [agyfs080].
However, some patients (7% propofol/propofol,
9% propofol/isoflurane, 9% propofol/sevoflurane,
8% sevoflurane/sevoflurane) said they would have
preferred to stay in longer because they felt they
needed more rest:
“No, I felt very sleepy. I was not really aware and I
can’t remember leaving” [agyfa780]
or they felt they would not be able to cope
at home:
“To be honest I felt they should have kept me in for
the first night. I have a young boy and my sister had
to have him’ [agyfs042].
A minority of the patients felt they were rushed
out of the hospital: