2021, Vol. 4, Issue 3, Part B
A prospective clinical audit on quality of anaesthesia and accidental awareness in patients undergoing elective surgery under general anaesthesia
Author(s): Dr. PR Chauhan, Dr. HK Mahajan, Dr. Abhinav Gupta, Dr. Shalu Singh, Dr. Lokesh, Dr. Ravinder Dhanerwa and Dr. Mrinal
Abstract: Background: In order to assess and improve quality of patient care in perioperative period, knowledge of patient perspective is most important. A Prospective Clinical Audit was done on Quality of Anaesthesia and Accidental Awareness in patients undergoing elective surgery under General Anaesthesia.
a) The primary aim is to assess the quality of peri-operative anaesthesia care and patient satisfaction using a validated patient reported outcome measure.
b) To establish an estimate of accidental awareness during general anaesthesia.
Settings and Designs: This was a cross-sectional, prospective audit on elective post-operative patients who underwent surgery under routine balanced general anaesthesia at a tertiary health care centre. Total 94 post-operative cases, who underwent surgery within last three months, were included in the audit.
Material and Methods: Audit protocol was presented to competent Institutional Ethics committee and approval taken. The patients included in the audit had received routine balanced general anaesthesia for their surgery along with prophylactic analgesic, antiemetic and antacid intra-operatively. Anaesthetists randomly visited to the patients 24 hours after surgery and distributed structured questionnaires to the participants. Basic demographic information was collected from medical record and patients. We used Bauer Patient Satisfaction Questionnaires to obtain data regarding anaesthesia related discomfort and Modified Brice Questionnaire was used to assess Accidental Awareness during Anaesthesia.
Statistical Analysis: SPSS software for Windows version 21.0 was used for data analysis. Categorical data was presented as frequency and proportion whereas continuous data was presented as mean and Standard Deviation.
Results: Mean age of study subjects was- 51.81(16.82). Most of the cases belonged to ASA Grade III&IV (82.9%). When evaluating the questions on anaesthesia-related discomfort, the most frequent complaint of "pain at the surgical site" (54.26%), irritation in throat/sore throat in (39.36%), thirst (36.17%) and (23.40%) patients were drowsy after recovery from anaesthesia. Overall satisfaction rate was 100%, with care provided by Anaesthesia Department. However, 8.51% and 3.19% patients were not satisfied with pain therapy after surgery and information provided by the anaesthetist respectively. More than half (57.45%) could recall the voices they heard was the first thing to happen after waking up from anaesthesia and 9 (9.57%) could feel endotracheal tube in their throat during recovery from anaesthesia. We found one (1.06%) incidence of intraoperative AAA (Accidental Awareness during Anaesthesia).
Conclusion: Only one fourth patients were drowsy immediate after surgery and (9.57%) could feel endotracheal tube in their throat during recovery from anaesthesia. High risk group (ASA III and IV) were at higher risk (1.06% in our audit) for Accidental Awareness during Anaesthesia.
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How to cite this article:
Dr. PR Chauhan, Dr. HK Mahajan, Dr. Abhinav Gupta, Dr. Shalu Singh, Dr. Lokesh, Dr. Ravinder Dhanerwa, Dr. Mrinal. A prospective clinical audit on quality of anaesthesia and accidental awareness in patients undergoing elective surgery under general anaesthesia. Int J Med Anesthesiology 2021;4(3):128-133. DOI: 10.33545/26643766.2021.v4.i3b.293