Why patients choose regional anesthesia for orthopedic and trauma surgery.
BACKGROUND
While both surgeons' and anesthesiologists' preference of regional over general anesthesia is increasing, the patients' preference remains limited. Little is known about why patients choose regional anesthesia. The aim of our study was to answer this question with regard to orthopedic and trauma surgery.


METHODS
The study was carried out prospectively from 1999 to 2001 and included 238 patients scheduled for arthroscopy of the lower limb or other orthopedic or trauma surgery. All patients were informed about regional and general anesthesia in a pre-anesthesia interview and subsequently chose the method they preferred.


RESULTS
Curiosity was the main reason why patients chose regional anesthesia for arthroscopy ( n=155, p<0.0001). For all other types of orthopedic or trauma surgery ( n=83), patients chose regional anesthesia to avoid postoperative pain ( p<0.01) and/or the side-effects of general anesthesia ( p<0.0001). Younger ( n=128) and low-risk ( n=184) patients chose regional anesthesia because they were curious ( p<0.01 and p<0.001, respectively), while older ( n=110) and unhealthier patients ( n=56) did so for safety ( p<0.01 and p<0.001, respectively).


CONCLUSIONS
Patients choose different types of regional anesthesia for different reasons. While spinal anesthesia and femoral and sciatic block were chosen for curiosity reasons, brachial plexus block was chosen to avoid the side effects of general anesthesia. The patients' choice of regional anesthesia for orthopedic and trauma surgery is significantly influenced by the type of surgery, age, and health.
Department of Anesthesiology and Critical Care Medicine, Trauma Center Lorenz Boehler, Donaueschingenstrasse 13, 1200 Vienna, Austria. lindapel@via.at
Linda E
LE
Pelinka
Hartmut
H
Pelinka
Martin
M
Leixnering
Walter
W
Mauritz
D000328:Adult; D000367:Age Factors; D000368:Aged; D000768:Anesthesia, General / Q000379:methods / Q000706:statistics & numerical data*; D000772:Anesthesia, Local / Q000379:methods / Q000706:statistics & numerical data*; D001182:Arthroscopy / Q000379:methods*; D001294:Attitude to Health; D003657:Decision Making; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010358:Patient Participation; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012737:Sex Factors