Patient/anesthesiologist intersubjective experiences and intravenous supplementation during elective cesarean delivery: A prospective patient-reported outcome study
S. Orbach-Zinger , E. Olliges , A. Garren , K. Azem , S. Fein , P. Heesen , H. Sharvit , R. Shani , Z. Haitov , J. Ronel , Y. Binyamin
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Abstract
Introduction
This prospective, observational study investigated the impact of patient/anesthesiologist interactions and socioeconomic factors on administering intravenous analgesics and anxiolytics during elective Cesarean delivery under spinal anesthesia. The study explored the role of emotional experiences and psychosocial characteristics on intraoperative administration of intravenous adjuncts.
Methods
The study included 502 patient/anesthesiologist dyads from two hospitals in Israel. Patients and anesthesiologists completed questionnaires assessing pain, anxiety, medication requests, and subjective experiences. Logistic regression models were used to analyze associations between variables and medication administration.
Results
Out of 502 patients, 110 (21.9 %) received intravenous supplementation. Only 40.6 % of patients who requested analgesics received them, while anxiolytics were administered four times more often than analgesics. Patients with higher salaries and those speaking the same language as the anesthesiologist were less likely to receive supplementation. Anesthesiologists feeling more attached to or close to patients were more likely to administer medication, while those motivated to protect patients were less likely.
Conclusion
The study revealed a substantial gap between patient requests for analgesics and their administration, as well as an overreliance on anxiolysis compared to analgesia. Unconscious attitudes related to patient factors and subjective physician perceptions played a role in medication decisions. The findings emphasize the need for better pain assessment and management training, and awareness of implicit biases in healthcare settings. Future research should investigate optimal communication strategies and address unconscious attitudes to improve patient-centered care.
期刊介绍:
The Journal of Clinical Anesthesia (JCA) addresses all aspects of anesthesia practice, including anesthetic administration, pharmacokinetics, preoperative and postoperative considerations, coexisting disease and other complicating factors, cost issues, and similar concerns anesthesiologists contend with daily. Exceptionally high standards of presentation and accuracy are maintained.
The core of the journal is original contributions on subjects relevant to clinical practice, and rigorously peer-reviewed. Highly respected international experts have joined together to form the Editorial Board, sharing their years of experience and clinical expertise. Specialized section editors cover the various subspecialties within the field. To keep your practical clinical skills current, the journal bridges the gap between the laboratory and the clinical practice of anesthesiology and critical care to clarify how new insights can improve daily practice.