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AMBULATORY ANESTHESIA

What Determines Patient Satisfaction with Cataract Care Under Topical Local Anesthesia and Monitored Sedation in a Community Hospital Setting?

Donald Fung, MD, MSc^*, Marsha M. Cohen, MSc, MD, Susan Stewart, BSc, MA, and Andy Davies, MD^*

*North Bay General Hospital, North Bay, and Department of Anesthesia, Faculty of Medicine, University of Toronto, Toronto; Centre for Research in Women’s Health, Sunnybrook & Women’s College Health Sciences Centre and the Department of Health Policy, Management & Evaluation, University of Toronto, Toronto; and North Shores District Health Council, North Bay, Ontario, Canada

Address correspondence and reprint requests to Donald Fung, North Bay General Hospital, 750 Scollard, North Bay, Ontario, Canada. Address e-mail to dfung{at}cogeco.ca.

The Iowa Satisfaction with Anesthesia Scale (ISAS) is a reliable and valid tool to measure patient satisfaction with monitored anesthesia care. We used the ISAS to discover determinants of patient satisfaction with cataract care under topical local anesthesia and monitored sedation in a small community hospital. The ISAS (scored 1 to 6) was administered to 306 patients immediately after cataract surgery. All patients received topical local anesthesia and IV sedation administered by an anesthesiologist. Patient satisfaction was high: mean ISAS was 5.6 (sd 0.46; range: 3.3–6.0). The incidence of intraoperative and postoperative pain was 13% and 37%; other adverse events were infrequent (<5%). In multivariable logistic regression, significant predictors of satisfaction were postoperative pain (odds ratio [OR]: 4.84; 99% confidence interval [CI]: 2.21, 10.60), surgeon (OR: 0.21; 99% CI: 0.05, 0.91), and preoperative anxiety (OR: 1.17; 99% CI: 1.03, 1.34). ISAS mean scores (OR = 0.28; 99% CI: 0.13, 0.59) and preoperative anxiety (OR = 1.12; 99% CI: 0.99, 1.28) emerged as significant predictors of low rating of quality of experience. Our results indicate that the ISAS can be used to track patient satisfaction with monitored cataract care. Pain during and after cataract surgery is common and is a major reason for lower patient satisfaction with their cataract care.

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Anesthesia & Analgesia® is published for the International Anesthesia Research Society® by Lippincott Williams & Wilkins with the assistance of Stanford University Libraries' HighWire Press®. Copyright 2006 by the International Anesthesia Research Society. Online ISSN: 1526-7598   Print ISSN: 0003-2999