Patients Undergoing Hybrid Revascularisation Under Regional Anesthesia With a Prolonged Procedure Time: Challenges...

The purpose of this study was to investigate current practices and the experiences of patients undergoing hybrid revascularisation under regional anesthesia with a prolonged procedure time.

A study using a multimethod approach was conducted using: (1) chart reviews, (2) staff questionnaires, and (3) patient interviews.

In a Danish regional acute hospital, retrospective chart reviews were conducted from May 2022 to May 2023. A survey among anesthesia staff was conducted in June/July 2023, and semi-structured patient interviews were conducted from October 2023 to September 2024. Quantitative data were analyzed with descriptive statistics, and qualitative data were analyzed with thematic analysis.

The chart review included 30 patients. The most frequently used drug for sedation was propofol, with an average dose of 1 mg/kg/hr, often increasing over time. None of the charts showed the use of a sedation scale. There was a lack of documentation of positioning checks. The staff survey included 35 (70%) healthcare professionals. Only half of the anesthesia providers knew of the local guideline for sedation, and only a few of those who knew it existed used it. Sedation doses were based on professional but individual discretion rather than on a recommended dose. Patient interviews (eight) showed that the patients were generally well satisfied, even though all had postoperative pain and general discomfort related to the procedure immobilization. Unexpected postoperative issues caused the most frustration and discomfort.

Documentation of intraoperative care was lacking, and, despite a guideline, the approach to sedation was individual. Even though the patients were generally well satisfied with the procedure, there were issues with pressure injuries and unexpected postoperative discomfort.