Robotic-Assisted Thyroidectomy: A New Experience in Anaesthesia

This is our first experience in providing general anaesthesia for robotic-assisted thyroidectomy (RAT). It is rather a new experience for our anaesthetic team and few issues should be addressed. The conduct of RAT must be fully understood and familiarized as it may present with few challenges for the anaesthesiologists. The key point of success during this learning curve period is the importance of teamwork between the anaesthesiologists and the operating surgeons. The specific anaesthetic challenges include limited access to the patient post-docking of the robot, the need of extra precautions of the anaesthetic circuit and IV line connections, a vigilant anaesthesiologists and options for postoperative pain relief.

Validation of the Malay version of the Amsterdam Preoperative Anxiety and Information Scale (APAIS).

BACKGROUND: Preoperative anxiety is a significant problem worldwide that may affect patients' surgical outcome. By using a simple and reliable tool such as the Amsterdam Preoperative Anxiety and Information Scale (APAIS), anaesthesiologists would be able to assess preoperative anxiety adequately and accurately. OBJECTIVE: The purpose of this study was to develop and validate the Malay version of APAIS (Malay-APAIS), and assess the factors associated with higher anxiety scores. METHODS: The authors performed forward and backward translation of APAIS into Malay and then tested on 200 patients in the anaesthetic clinic of University Malaya Medical Centre. Psychometric analysis was performed with factor analysis, internal consistency and correlation with Spielberger's State-Trait Anxiety Inventory (STAI-state). RESULTS: A good correlation was shown with STAI-state (r = 0.59). Anxiety and need for information both emerged with high internal consistency (Cronbach's alpha 0.93 and 0.90 respectively). Female gender, surgery with a higher risk and need for information were found to be associated with higher anxiety scores. On the other hand, previous experience with surgery had lower need for information. CONCLUSION: The Malay-APAIS is a valid and reliable tool for the assessment of patients' preoperative anxiety and their need for information. By understanding and measuring patient's concerns objectively, the perioperative management will improve to a much higher standard of care.