Evaluation of factors associated with patient satisfaction and mood-state in regional anesthesia.

OBJECTIVES: This study was designed to evaluate patient satisfaction with a regional anesthesia procedure and factors associated with the mood state of those patients at the time. METHODS: The study was performed with 300 patients who underwent surgery under regional anesthesia. The patients were given a questionnaire while in the recovery room about the experience of undergoing regional anesthesia to determine patient satisfaction and mood state during the procedure. RESULTS: The overall level of satisfaction with regional anesthesia was 82.3%. The level of satisfaction was higher in the age group of 18-25 years, male gender, in patients who had a previous regional anesthesia experience, and in patients who were well informed about regional anesthesia in a preoperative anesthetic evaluation. There was a relationship between pain due to failed spinal anesthesia during surgery and dissatisfaction with regional anesthesia. Patients who were properly informed preoperatively mostly expressed the feeling of 'safe.' Patients who underwent urological interventions most often expressed the feeling of 'comfortable'. Patients underwent gynecological and obstetrical surgeries mostly expressed the feeling 'excited'. Patients who underwent general surgical procedures and patients who were not informed preoperatively about regional anesthesia most often reported feeling 'anxious.' CONCLUSION: Providing adequate preoperative information to the patient about regional anesthesia will increase overall satisfaction and will assure the patient feels safe during the perioperative period. CLINICAL TRIAL REGISTRATION NUMBER: NCT03476278.

Comparison of Risk Scoring Systems to Predict the Outcome in ASA-PS V Patients Undergoing Surgery: A Retrospective Cohort Study.

Operative decision in American Society of Anesthesiology Physical Status (ASA-PS) V patient is difficult as this group of patients expected to have high mortality rate. Another risk scoring system in this ASA-PS V subset of patients can aid to ease this decision. Data of ASA-PS V classified patients between 2011 and 2013 years in a single hospital were analyzed in this study. Predicted mortality of these patients was determined with acute physiology and chronic health evaluations (APACHE) II, simplified acute physiology score (SAPS II), Charlson comorbidity index (CCI), Porthsmouth physiological and operative severity score for enumeration of mortality and morbidity (P-POSSUM), Surgical apgar score (SAS), and Goldman cardiac risk index (GCRI) scores. Observed and predicted mortality rates according to the risk indexes in these patients were compared at survivor and nonsurvivor group of patients. Risk stratification was made with receiver operator characteristic (ROC) curve analysis. Data of 89 patients were included in the analyses. Predicted mortality rates generated by APACHE II and SAPS II scoring systems were significantly different between survivor and nonsurvivor group of patients. Risk stratification with ROC analysis revealed that area under curve was 0.784 and 0.681 for SAPS II and APACHE II scoring systems, respectively. Highest sensitivity (77.3) is reached with SAPS II score. APACHE II and SAPS II are better predictive tools of mortality in ASA-PS V classified subset of patients. Discrimination power of SAPS II score is the best among the compared risk stratification scores. SAPS II can be suggested as an additional risk scoring system for ASA-PS V patients.

A Comparison of Three Widely Used Immunoassay Systems in Cortisol Measurement.

BACKGROUND: Interassay variability is one of the challenging issues of routine clinical laboratory practice. Commercial plasma cortisol immunoassays are also subject to this issue. In this study, we intended to evaluate the interchangeability of cortisol results of three widely used immunoassay systems. METHODS: The cortisol values of 150 serum samples measured by three immunoassay systems, Beckman Coulter DXI 800, Roche Modular E170, and Siemens Immulite 2500, were compared. RESULTS: A degree of proportional biases was observed between all three methods; DXI 800 showed the worst biases with the other two systems (slope values 0.67 and 0.77 with E170 and Immulite 2500, respectively). DXI 800 showed poor agreement with other methods (CCC: 0.83 and 0.87, respectively). There was a moderate agreement between E170 and Immulite 2500 (CCC: 0.92). CONCLUSIONS: All three methods showed a degree of variability among themselves. DXI 800 results were not interchangeable with the other two systems.