BJA open · 2026
Exploring clinician and patient perspectives on choice of general anaesthetic. A report of two U.S. surveys: an anesthesia clinician Multicenter Perioperative Outcomes Group survey and a patient Amazon Mechanical Turk survey.
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Holzer Katherine J, Hurwitz Rachel M, Tellor Pennington Bethany R, Politi Mary C, Vaughn Michelle T, Chu Larry, Price Amy, Hicks Melissa, Avidan Michael S, Kheterpal Sachin
Аннотация
BACKGROUND: Inhalation anaesthesia or propofol-based TIVA are the two primary options for administering general anaesthesia. Shared decision-making between clinicians and patients is critical. This study explores the perspectives of both anesthesia clinicians and patients on general anaesthesia techniques, aiming to identify gaps in communication and decision-making.
METHODS: Two surveys were conducted in December 2020: an 18-item clinician survey disseminated through the Multicenter Perioperative Outcomes Group to clinicians who administer general anesthesia and a 33-item patient survey distributed via Amazon Mechanical Turk to individuals who had undergone surgery using general anaesthesia. The clinician survey focused on preferences regarding use of general anaesthesia techniques, discussion practices, and perceived barriers to TIVA use. The patient survey assessed preoperative discussions and preferences for anaesthetic techniques. Data were analysed using descriptive statistics.
RESULTS: Of the 1123 anesthesia clinician respondents [comprised mostly of anaesthesiology attendings (47.8%) or Certified Registered Nurse Anesthetists (CRNAs, 34.6%)], when asked if they or a family member required general anaesthesia; 40% preferred TIVA, 13% preferred inhalation anesthesia and 33% indicated no preference. Nearly 80% of clinicians did not routinely discuss general anaesthetic technique options with patients. Among the 509 eligible patients (mean age: 38.1 yr), 65% reported that their anaesthesia team discussed general anaesthesia options, and 63% were offered a choice. Both anesthesia clinicians and patients identified intraoperative awareness risk and recovery quality as important factors influencing preferences.
CONCLUSIONS: This study highlights discrepancies between patient perceptions of shared decision-making and anesthesia clinicians' reported practices for general anesthesia techniques in US hospitals. Further comparative studies are needed to address these communication gaps and support evidence-based shared decision-making in anaesthetic care.
METHODS: Two surveys were conducted in December 2020: an 18-item clinician survey disseminated through the Multicenter Perioperative Outcomes Group to clinicians who administer general anesthesia and a 33-item patient survey distributed via Amazon Mechanical Turk to individuals who had undergone surgery using general anaesthesia. The clinician survey focused on preferences regarding use of general anaesthesia techniques, discussion practices, and perceived barriers to TIVA use. The patient survey assessed preoperative discussions and preferences for anaesthetic techniques. Data were analysed using descriptive statistics.
RESULTS: Of the 1123 anesthesia clinician respondents [comprised mostly of anaesthesiology attendings (47.8%) or Certified Registered Nurse Anesthetists (CRNAs, 34.6%)], when asked if they or a family member required general anaesthesia; 40% preferred TIVA, 13% preferred inhalation anesthesia and 33% indicated no preference. Nearly 80% of clinicians did not routinely discuss general anaesthetic technique options with patients. Among the 509 eligible patients (mean age: 38.1 yr), 65% reported that their anaesthesia team discussed general anaesthesia options, and 63% were offered a choice. Both anesthesia clinicians and patients identified intraoperative awareness risk and recovery quality as important factors influencing preferences.
CONCLUSIONS: This study highlights discrepancies between patient perceptions of shared decision-making and anesthesia clinicians' reported practices for general anesthesia techniques in US hospitals. Further comparative studies are needed to address these communication gaps and support evidence-based shared decision-making in anaesthetic care.