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

Shafic Sraj1, Brendan J Farley1, John S Taras1

  • 1Department of Orthopaedics, West Virginia University, PO Box 9137, Morgantown, WV.

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|November 24, 2024
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Summary

Patients undergoing office-based hand surgery reported less distress than expected, particularly those with higher preoperative anxiety scores. This suggests that anxiety may not predict a worse experience during local anesthesia procedures.

Keywords:
DistressWALANToffice-based hand surgerypatient experiencewide-awake surgery

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Area of Science:

  • Orthopedic Surgery
  • Anesthesiology
  • Psychology

Background:

  • Office-based surgery offers a safe and satisfactory alternative for many patients.
  • Patient apprehension regarding being awake during procedures can increase preoperative anxiety.
  • Preoperative anxiety is a potential risk factor for adverse postoperative outcomes.

Purpose of the Study:

  • To evaluate patient distress levels before, during, and after office-based hand surgery.
  • To identify patient-specific factors associated with distress during these procedures.
  • To investigate the relationship between preoperative anxiety and intraoperative/postoperative distress.

Main Methods:

  • A cohort of 57 patients undergoing office-based hand surgery was studied.
  • Patients completed the Amsterdam Preoperative Anxiety and Information Scale (APAIS) preoperatively.
  • The Subjective Units of Disturbance Scale (SUDS) was used to assess distress related to specific domains at multiple time points.

Main Results:

  • Patients reported lower distress levels than their preoperative expectations across all assessed domains.
  • A significant majority of patients (81-96%) found their surgical experience to be as good as or better than anticipated.
  • Elevated APAIS scores correlated with a greater likelihood of experiencing less distress than expected.

Conclusions:

  • Office-based hand surgery under local anesthesia generally results in less patient distress than anticipated.
  • Preoperative anxiety, as measured by APAIS, did not correlate with increased distress during the procedure.
  • Patients with higher preoperative anxiety reported better-than-expected experiences, challenging the assumption that anxiety predicts poorer outcomes.