Effect of patient-controlled sedation with propofol on patient satisfaction: A randomized study

Escort of older people into the operating room: A feasibility study

BACKGROUND

While special care is given to perioperative risk assessment and management of older people undergoing surgery, psychological aspects have been largely neglected. Escort presence in the operating room (OR) is common practice in the surgical paediatric and obstetric populations and may be beneficial in older people.

OBJECTIVES

This study explored the feasibility of family member escort of older people into the OR and their presence until induction of anaesthesia.

METHODS

Prospective observational study of older people (>70 years) undergoing surgery, who were offered an escort into the OR. The primary end point was the proportion of relatives who completed the intervention without feeling dizzy or fainting. Secondary end points related to patient, escort and medical and nursing staff perception of the process.

RESULTS

Forty-four sets of patients and escorts completed the process. The primary objective assessing feasibility was concluded successfully. Secondary objectives assessed (1) satisfaction, where 93% of escorts and 75% of patients would support a repeat of this process; (2) anxiolysis, where 61% of patients reported a reduced level of anxiety; (3) although 68% of anaesthesiologists agreed this process improved patients' well-being, most nurses and anaesthesiologists believed this should not become routine practice. Interestingly, most staff support parents escorting a paediatric patient into OR.

CONCLUSIONS

This is the first study exploring the feasibility of escorting older people into the OR. It shows a unique insight into patient- and family-centred care of the surgical older person. Escort presence may help alleviate anxiety and increase satisfaction. The medical and nursing staff objections must be looked at further.

Computer-Assisted and Patient-Controlled Sedation Platforms

As the number and complexity of endoscopic procedures increase, the role of sedation has been integral in patient and physician satisfaction. This article discusses the advances of computer-assisted and patient-controlled platforms. These computer-assisted and patient-controlled platforms use different anesthetics and analgesics, all with the intent of achieving improved consistency in the level of sedation, appropriate to the needs of patients, while also improving patient safety. These systems have been around for decades; however, few are approved for use in the United States, and several still require further study before broad clinical application.