[Evaluation of patient satisfaction with anesthesia care]

The assessment of patient satisfaction with anesthesia, the balance between expectations and perception of what was received, is an essential component of continuous quality improvement in anesthesiology. In our center there have been few studies conducted in the anesthesia field, which have assessed patient's satisfaction. In this prospective study we have evaluated patient satisfaction with anesthesia in patients 24 h after surgery. This study was performed in Sina hospital in Tehran, Iran on patients aged more than 18 yr. They all underwent elective surgical procedures with anesthesia. One of the anesthesia staff members took the interview one day after surgery and asked the patients questions for the structured questionnaire designed to measure patient satisfaction with anesthesia. At the same time, some specific questions were also asked to find factors that could be associated with such satisfaction. The data was gathered from 500 patients [mean age: 41 +/- 16 yr; and males: 65.2%]. The overall satisfaction [complete and relative] was high [98.8%]; although 6 patients [1.2%] were dissatisfied with their anesthesia care. After analysis of several factors related to the patients' surgery and anesthesia, a strong relation was found between spinal anesthesia and satisfaction [p=0.003].There was not any relation between age, gender, education, duration of anesthesia and kind of surgery with patients' satisfaction. Our study found that patient satisfaction with anesthesia was very high in our center and the only factor that increased patient's satisfaction was spinal anesthesia

[Evaluation of oral clonidine effects on prevention of post-anesthesia shivering]

Shivering is a common post anesthesia complication. Intravenous Clonidine administration at induction of anesthesia is a useful drug for decreasing of incidence and severity of post-anesthesia shivering. As Clonidine injection can induce side effects therefore we evaluated the oral Clonidine premedication on post-anesthesia shivering. In a RCT, 60 adult patients in ASA class 1 and 2 scheduled for cholecystectomy were assigned to 2 groups. 2 hours before anesthesia, 0.2 mg oral Clonidine was administrated and to the other group placebo was administered. Surgery room temperature was adjusted for 21-23[degree][c]. At the end of the anesthesia, the patients' shivering was evaluated in the recovery room by "Crossley andMahajan shivering score". There was no difference at decrease of SpO2 and H.R. and MAP between 2 groups. There was no difference in average time of emergence between 2 groups. Overall 75% of the patients shivered after anesthesia. Median shivering score in clonidine group was 1.97 and in placebo were 2.87. It became revealed that there was clear difference at shivering score between 2 groups [less severe or generalized shivering patients in test group]. 0.2 mg Clonidine tablet, 2 hours before anesthesia is similar to injecting drug and is effective in prevention of post-anesthesia shivering but its complication is less. Lack of difference at hemodynamics and SpO2 and emergence in our study may be due to slow absorption of oral Clonidine