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Can the Iowa Satisfaction with Anesthesia Scale be used to measure patient satisfaction with cataract care under topical local anesthesia and monitored sedation at a community hospital?

North Bay General Hospital, 750 Scollard, North Bay, Ontario, Canada.
Anesthesia & Analgesia (Impact Factor: 3.42). 07/2005; 100(6):1637-43. DOI: 10.1213/01.ANE.0000154203.00434.23
Source: PubMed

ABSTRACT Patient satisfaction ratings provide a means to evaluate and monitor quality of health care. We tested the ability of the Iowa Satisfaction with Anesthesia Scale (ISAS) to measure satisfaction with cataract care under topical local anesthesia and monitored sedation given by an anesthesiologist at a community hospital. Three hundred six patients were administered the ISAS along with alternate ratings of quality of care and patient satisfaction. There were no incomplete questionnaires. The ISAS demonstrated reasonable reliability (Cronbach's alpha = 0.68; test-retest = 0.48-0.67). The ISAS had excellent construct validity; ISAS scores were lower in patients who gave lower ratings of quality (4.98 versus 5.64), who had lower satisfaction visual analog scale scores (5.12 versus 5.65), who wanted changes in their care (4.76 versus 5.67), who had suggestions to improve care (5.08 versus 5.63), or who preferred more sedation (4.85 versus 5.66) (P < 0.0001). Our results indicate that the ISAS questionnaire is a feasible, reliable, and valid tool to measure patient satisfaction in patients undergoing cataract surgery under topical anesthesia and monitored sedation.

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    ABSTRACT: Background and purpose of study. The purpose of our study was to assess safety and efficacy of cataract surgery (CS) under topical anesthesia alone, i.e. without pre-anesthetic evaluation and without direct presence of an anesthesiologist. To this end we assessed the incidence of patients' preoperative anxiety, perioperative adverse events and patients' and surgeons' satisfaction. Materials and methods. Patients undergoing CS under topical anesthesia over a one-month period were included. An anesthesiologist and nurse anesthetist were present in the area and could intervene in case of an adverse event. Patients' anxiety was scored using the Amsterdam Preoperative Anxiety a Information Scale (APAIS), and their satisfaction with the Iowa Satisfaction with Anesthesia Scale (ISAS). Surgeons' satisfaction was scored with a VAS from 0 to 10 (0: surgery not possible a 10: excellent surgical conditions). Results and discussion. One hundred and twenty-four consecutive patients were included; mean age was 71 (+/- 9.4) years. Mean APAIS I was 6.4/20 (+/- 3.7). Mean APAIS II was 3.1 (+/- 1.8). Mean ISAS score was 5.5/6 (+/- 0.6), indicating high patient satisfaction. Surgeon satisfaction score was 8.9/10 (+/- 1.7). Twenty-three adverse events occurred of which 16 required interventions by the anaesthesiologist or surgeon: 5 supplemental local or regional anaesthesia, 6 iv-analgesia, 5 management of hypertension. Conclusion. These preliminary data suggest that a simplified topical anesthesia protocol for ambulatory CS appears to be feasible and safe, as long as an anesthesia team is present in the area to intervene if needed.
    Journal francais d'ophtalmologie 07/2014; 37(7). DOI:10.1016/j.jfo.2014.05.003 · 0.36 Impact Factor
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    ABSTRACT: The Iowa Satisfaction with Anesthesia Scale (ISAS) was rigorously developed and has been shown to be valid and reliable for evaluating patient satisfaction with monitored anesthesia care (MAC) in several scenarios. Such an instrument is important given the success that MAC is enjoying in the field. Objective Validate the ISAS in Spanish and establish indicators of validity and reliability in patients undergoing ophthalmic surgeries with MAC. Methods A translation and back-translation of the scale, face validity and pilot tests for adjustments were completed. The final instrument was applied to 117 subjects over18 years of age, ASA I–III, in two healthcare institutions in Villavicencio (Meta Department, Colombia) in order to measure the concurrent criterion validity between the patients and the anesthesiologist of the case. The internal consistency of the scale was established in its first application to the subjects and later applied for the second and third times to verify the test–retest reliability. Results A Pearson anesthesiologist/patient concurrent criterion validity 0.85 CI 95% (0.79–0.89), intra-class 0.82 CI 95% (0.77–0.88), was confirmed. Internal consistency was measured with a Cronbach's alpha of 0.71. Test–retest reliability (40–65 min) was measured with Pearson and intra-class 0.95 CI 95% (0.93–0.96) and, (12–36 h) Pearson 0.65 CI 95% (0.52–0.75), intra-class 0.64 CI 95% (0.53–0.76). Conclusions The validation of the ISAS in Spanish allows for the use of a valid and reliable instrument to objectively measure the satisfaction of the patient in ophthalmic surgery under MAC.
    Revista Colombiana de Anestesiologia 10/2014; 42(4). DOI:10.1016/j.rca.2014.07.008
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    ABSTRACT: Cataract is one of the most common surgical procedures in the elderly. In most cases, the elderly have cardiac ischemia or chronic coronary diseases, which would lead to more ischemic events during general anesthesia. Therefore, surgeons and anesthetists prefer regional aesthesia to the general one owing to its more advantages and less complications. Therefore, this study aimed to compare topical method and retrobulbar block for pain intensity, patient's satisfaction, hemodynamic changes and intra and postoperative complications. In a single-blinded clinical trial, 114 patients scheduled for cataract surgery, aged 50 to 90 years with ASA physical status of I-III, were randomly assigned to two groups under monitored anesthesia care as topical anesthesia and retrobulbar block. After the injection of intravenous sedation, which was the combination of midazolam 0.5-1 mg with fentanyl 0.5-1 µ/kg, patients received retro bulbar block or topical anesthesia. During the operation, heart rate, systolic and diastolic blood pressure, mean arterial blood pressure and arterial saturation of O2were measured every five minutes. In addition, pain (VAS) and satisfaction (ISAS) scores were recorded every 15 minutes, then at recovery and one hour after the ending of operation in the ward. Findings were statistically analyzed using SPSS 16. In this study, no significant association was found between age, gender, education and physical condition of patients in both topical and retro bulbar block groups. Comparison of pain based on VAS, satisfaction based on ISAS score and MAP in the studied periods had no significant differences between the two groups of patients undergoing cataract surgery. However, significant differences were found between the two groups (P = 0.045, 0.02, 0.042 and P < 0.05) regarding heart rate, systolic and diastolic blood pressure and arterial oxygen saturation percentage after 20-30 minutes of the operation. Both methods, topical and retro bulbar block had similar impression in cataract surgery regarding analgesia and patient satisfaction. However, in non-complicated cataract surgeries with short duration, topical anesthesia may be the preferable method, because of non-invasiveness, appropriate analgesia, patient satisfaction and hemodynamic stability.
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