Preoperative anxiety after face-to-face patient assessment versus preanaesthesia telemedicine (PANTEM) in adults: a randomised clinical trial.

Preanaesthesia consultation is performed to assess and optimise patient-specific risk factors before surgery, to inform patients about anaesthesia techniques and to obtain consent. Aside from face-to-face visits, telephone consultation is increasingly being used clinically. Concentration on the content and avoidance of confounding factors could lead to improved patient preparation. We hypothesised that patients receiving a telemedical intervention have less anxiety. Patients scheduled for elective surgery were randomised into two groups according to the consultation performed face-to-face (FTF) or via telephone (TEL). Before consultation (< 48 h) and 1-2 h prior to surgery, both groups had to fill in the State-Trait Anxiety Inventory (STAI). A total of 271 patients were randomised and 130 were analysed. There were no significant intergroup differences in mean state anxiety (STAI-S) before and after the intervention. Patients' positive feedback on telemedical consultation urges future studies on its effect on satisfaction and quality of life.

[Preoperative risk clarification and anesthesia disclosure by telephone conversation]. / Präoperative Risikoabklärung und Anästhesieaufklärung mittels Telefonvisite.

BACKGROUND: Preoperative risk stratification, patient optimization and anesthesia disclosure are mostly carried out in the preanesthesia outpatient department in a direct conversation between physician and patient. The aim of this article is a description of the preanesthesia telephone contact as an alternative disclosure and clarification option for the clinical practice. METHODS: After clarification of data protection and medicolegal aspects, experiences with providing information via telephone in a single center were gathered. RESULTS: Initially, before spinal operations pain patients with unreasonably long access routes to the preanesthesia outpatient department received clarification and disclosure via the telephone. Due to the effectiveness and the lack of medical and processual complications, after 1 year the offer of a telephone conversation was extended to all patients. In the meantime, 47% of preanesthesia conversations are now carried out by telephone. Factors relevant for success are the consent of the patient to a telephone conversation, a multimedia patient education before the telephone conversation, competence of the anesthetist in communication, documentation and a clearly defined description of the process including changeover to the direct conversation. CONCLUSION: The preanesthesia telephone conversation is suitable as an alternative to the preanesthesia conversation in the outpatient department. High patient satisfaction results from the patient-oriented process, avoidance of transportation routes and the participative communication.