Anesthesiologist to Patient Communication: A Systematic Review

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Health Communication

Background:

• Incomplete recovery after surgery often leads to intensive care unit (ICU) admission.
• Preoperative discussions on patient values and preferences can guide care decisions for those with potential for prolonged recovery.
• Surgeons rarely discuss these topics preoperatively; the extent of anesthesia professional engagement is unclear.

Purpose of the Study:

• To systematically review existing literature on communication between patients and anesthesia professionals.
• To specifically examine discussions concerning postoperative critical care and patient values.

Main Methods:

• A systematic literature search was conducted in MEDLINE and Web of Science (1980-2020).
• Studies involving patient-anesthesia professional encounters were selected.
• Data on study design, outcomes, and communication content were extracted following PRISMA guidelines.

Main Results:

• 12 studies (1284 patient encounters) were included.
• Communication regarding postoperative care between patients and anesthesia professionals is infrequent (3.6% of consultations discussed adverse events).
• Discussions primarily focus on anesthetic planning and logistics, with limited exploration of patient values or risks/benefits.

Conclusions:

• Anesthesia-related communication predominantly covers preoperative planning, not postoperative critical care.
• Most patients admitted to the ICU post-surgery have not discussed goals of care for protracted recovery with their anesthesiologist.
• Enhancing preoperative communication regarding critical care is crucial for aligning patient preferences with medical decisions.