The efficiency of different adjunct techniques for regional anesthesia

Area of Science:

• Anesthesiology
• Psychology
• Health Economics

Background:

• Patient satisfaction and sedation are crucial during regional anesthesia for orthopedic surgery.
• Non-pharmacological interventions like music and explanations are explored as alternatives to sedation.
• Propofol and midazolam are common pharmacological agents for sedation in surgical settings.

Purpose of the Study:

• To compare the effectiveness and patient satisfaction of music/explanation, subliminal sound, propofol-controlled sedation (PCS), and midazolam versus a control group during orthopedic surgery under regional anesthesia.
• To evaluate the cost-effectiveness of using music and explanations as a sedation alternative.

Main Methods:

• A prospective, randomized controlled trial involving 110 unpremedicated patients undergoing orthopedic surgery under regional anesthesia.
• Patients were divided into five groups: explanation and music, subliminal sound, propofol (PCS), midazolam, and a control group.
• Patient satisfaction and sedation levels were assessed postoperatively.

Main Results:

• The midazolam group showed significantly higher sedation than the control group at 1 hour.
• Patients receiving explanation and music reported significantly lower satisfaction than the propofol group post-operation.
• Explanation and music intervention was cost-effective, saving 299.53 baht per patient, but decreased satisfaction by 17.26 points compared to propofol.

Conclusions:

• While music and explanation interventions offer cost savings, they result in lower patient satisfaction compared to propofol.
• Midazolam effectively increases sedation levels during regional anesthesia.
• Further research is needed to balance cost-effectiveness with optimal patient satisfaction in surgical sedation.