Audiovisual distraction as an anxiety-minimising adjuvant to regional anaesthesia in adult limb surgery: a service evaluation using patient reported experience measures

Abstract

Audiovisual distraction (AVD) is an expanding anxiety-minimising technique for patients undergoing surgery under regional anaesthesia (RA). We evaluated patient satisfaction with AVD in the setting of conscious RA for limb surgery using patient reported experience measures (PREMs). Service evaluation using PREMs, via standardised post-operative patient questionnaire, in a single tertiary referral centre for orthopaedic and plastic surgery over an 18-month period. Outcome measures included impact of AVD on peri-operative anxiety, comfort, satisfaction and comparison with previous general anaesthesia (GA) experiences. 50 adult patients undergoing elective limb surgery under RA ± sedation were provided with a wifi-enabled tablet device peri-operatively and completed a post-operative questionnaire regarding their AVD experience. 100% were satisfied with AVD and would recommend to others. 78% were anxious before or during the procedure, of which 97% felt that AVD improved their anxiety levels. Of the 94% with previous experience of GA, 89% reported a ‘better’ experience with RA + AVD. PREMs regarding AVD were encouraging and lay a foundation for further clinical service development and research into incorporation of this technique for appropriate RA patient groups. Our findings are particularly relevant in the COVID-affected era of anaesthesia as RA benefits and strategies to minimise anxiety are reappraised.

Keywords:

• Audiovisual distraction; regional anaesthesia; anxiety-minimising techniques; audiovisual technology in anaesthesia

Acknowledgements

We would like to thank the following colleagues with their assistance with the development of the technique and/or the service evaluation: Drs James Matthews, Warwick Pepper, Desi Choi, Anna Wallis, Mr Jonathan Bayliss, Mr Michael Ashfield, Mrs Tatiana Wood, Mr Alex Ramsden, Prof Dominic Furniss.

The preliminary results of our service evaluation were presented in as an E-abstract in Abstracts and highlight papers of the 35th Annual European Society of Regional Anaesthesia & Pain Therapy (ESRA) congress 2016.

Pepper, W., Athanassoglou, V., Matthews, J., & Galitzine, S. (2016). A survey of 50 patients undergoing awake surgery with audiovisual distraction, assessing the patient experience and comparing it to previous general anaesthesia. Regional Anesthesia & Pain Medicine, 41, e156.

Disclosure statement

No potential conflict of interest was reported by the author(s).