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

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Appendix 16
“No, I felt rushed. I was in a lot of pain/discomfort –
had to walk to the car. I had been told I’d be given a
wheelchair” [agnfc061].
Some patients (4% propofol/propofol, 5%
propofol/isoflurane, 6% propofol/sevoflurane,
3% sevoflurane/sevoflurane) felt they were kept in
the hospital too long and felt ready to go home
earlier than they did:
“Yes, I did actually, I was ready before I went. I was
held back as staff were busy” [agyfa882].
‘I was ready to go earlier – waiting for discharge
papers and sick note but I understood why”
[agnmc169].
Satisfaction with care
Overall (99%), the patients were very satisfied with
the care they received on the ward before their
operation. Satisfaction with preoperative care was
not dependent on the type of anaesthetic they
had received. Those patients who were not happy
referred to being unsettled by the wait before
their operation:
“Not really – left in recovery waiting before the
operation on own. I was cold and alone and I got
upset” [agyfs001].
“There was a very long delay – about 2 hours – that
was very unsettling” [agnmc010].
A slightly lower proportion of patients (97%
propofol/propofol, 95% propofol/isoflurane,
96% propofol/sevoflurane, 98% sevoflurane/
sevoflurane) were satisfied with the care they
received in the recovery area after their operation.
Those patients who were not happy referred to
poor communication by the staff:
“Not really – I was really drowsy, had to ask for
someone to give the diagnosis. There was poor
communication from the doctors – no explanation of
treatment” [agyfs001].
“Yes – except the news wasn’t good but I felt it wasn’t
appropriate for Mr xxx to tell me the bad news in
recovery and not to see me on the ward afterwards.
That’s why I felt I had to ring and clarify what was
said” [agyfa1119].
This patient was not happy with the level of pain
control they received:
“Not really no – I think there was not a lot of care –
they put me on the bed and left me in pain”
[agyfs055].
A similar proportion of patients (96%
propofol/propofol, 93% propofol/isoflurane,
93% propofol/sevoflurane, 96% sevoflurane/
sevoflurane) were satisfied with the care they
received after their operation on the ward. Those
patients who were not happy about their care
made comments about the staff or the service
regarding communication or discharge delays:
“No, in the day ward the nurses were moaning
about each other all the time, they were too busy
concentrating on the next day’s work. I felt I was a
nuisance” [agnfc010].
“Yes OK but the doctor was very abrupt in terms of
how he told me about my potential treatment and
dealt with me on the ward” [agyfs062].
“... bit of delay (to go home) – waiting for the tablets
from pharmacy” [agyfa256].
“I was left waiting for transport for 11/2 hrs because
someone forgot it” [agnmc027].
Days to recover after the operation
The patients were asked to recall how many days
it took them to recover from the operation and
resume their normal activities. About 1 in 10
patients (11% propofol/propofol, 12% propofol/
isoflurane, 16% propofol/sevoflurane, 13%
sevoflurane/sevoflurane), who were telephoned,
were not able to answer this question. No difference
was seen between three of the groups
(propofol/propofol, propofol/isoflurane,
sevoflurane/sevoflurane). On average, the patients
felt it took 5 days (95% CI, 4.2 to 5.9 propofol/
propofol; 95% CI, 4.3 to 5.7, propofol/isoflurane;
95% CI, 4.3 to 5.9, sevoflurane/sevoflurane)
for them to recover from their operation. The
propofol/sevoflurane group felt it took an average
of 6 days (95% CI, 5.1 to 6.9) for them to recover
from their operation.
Adult patients’ preferences for induction
Table 80 summarises the reasons why patients
would prefer the injection (medicine A) or the
mask (medicine B) to send them to sleep for a
future day procedure (see chapter 6 for the overall
number who preferred medicine A or B).
The majority of patients who preferred the
injection to the mask for a future induction
explained this was because they were frightened
of the mask:
“... because I think the injection is quicker and I can
imagine wanting to kick a person holding the mask
over my face, off me” [aorfc011].
Patients who had had the mask in the empirical
study had some concerns and were likely to prefer
an injection in future: