Patient Satisfaction With Different Anesthesia Types in Skin Cancer Reconstruction

Over 1 million skin cancer diagnoses are made each year. Although patients experience stress from the diagnosis, surgical management may cause additional anxiety reducing outcome and satisfaction scores. The authors sought to better understand the impact of local (local anesthesia [LA]) versus intravenous (IV) anesthesia, with the goal of optimizing treatment plans.

Patients who underwent Mohs micrographic surgery and subsequent reconstruction from 2019 to 2022 completed a survey evaluating satisfaction, pain, and anxiety at 1-week postop. Anesthesia type during reconstruction determined grouping, and analysis between the 2 groups was performed.

Of 78 patients, 30 received IV and 48 received LA. IV group (IVG) was significantly younger ( p = .01), had larger defects ( p = .04) and final reconstruction sizes ( p = .03). The IVG experienced significantly less anxiety during the procedure ( p = .02), however, reported more anxiety postoperatively ( p = .01). No significant differences regarding satisfaction or pain were identified.

Compared with LA, patients who underwent reconstruction with IV experienced significantly lower intraprocedural anxiety; however, the IVG experienced greater anxiety in the postoperative period. Despite this difference in anxiety, no significant difference was demonstrated in overall satisfaction. In conclusion, with patients undergoing a high anxiety procedure, it is important to tailor the treatment plan to decrease anxiety.