Perioperative Patient Experience in Office-Based Wide-Awake Hand Surgery.

Abstract

Purpose: Office-based surgery, is a safe, well-tolerated option associated with high patient satisfaction. However, some patients remain hesitant due to concerns of being awake during surgery. Preoperative anxiety may be linked to poorer postoperative outcomes. The purpose of this study was to examine patients' distress prior to, during, and following office-based hand surgery under local anesthesia and to identify patient variables associated with distress.

Methods: This study included 57 patients, 19 of whom had a history of anxiety and/or depression. Each patient completed the Amsterdam Preoperative Anxiety and Information Scale (APAIS) before surgery; patients completed the Subjective Units of Disturbance Scale (SUDS) before surgery, immediately after surgery, and at their first postoperative visit. They rated their SUDS with respect to the following distress domains: Being Awake During Surgery, Needlestick, Surgical Pain, and Discomfort.

Results: The average distress experienced was less than the patients' preoperative expectations across all domains, and most patients rated their experiences to be equivalent to or better than expected (81 to 96% of patients, depending on the domain). Patients with elevated APAIS scores were more likely to have less distress (a better experience) than expected compared to those who were not.

Conclusions: Average distress levels experienced were better than expected. Patients with higher APAIS had less distress (better experiences) than they expected.

Type of study/level of evidence: Prognosis II.