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Exploring patients’ anaesthetic preferences and perception of regional anaesthesia" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contieneTextoCompleto" => array:1 [ "es" => true ] "contienePdf" => array:1 [ "es" => true ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figura 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1165 "Ancho" => 2483 "Tamanyo" => 113633 ] ] "descripcion" => array:1 [ "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Nivel de ansiedad de los pacientes con relación a ser anestesiados y a estar despiertos durante la cirugía.</p>" ] ] ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.S. Lavado, D. Gonçalves, L. Gonçalves, C. Sendino, E. Valente" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J.S." "apellidos" => "Lavado" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Gonçalves" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Gonçalves" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Sendino" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Valente" ] ] ] ] ] "idiomaDefecto" => "es" "Traduccion" => array:1 [ "en" => array:9 [ "pii" => "S2341192919300514" "doi" => "10.1016/j.redare.2018.12.005" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192919300514?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S003493561830238X?idApp=UINPBA00004N" "url" => "/00349356/0000006600000004/v1_201903290609/S003493561830238X/v1_201903290609/es/main.assets" ] ] "itemSiguiente" => array:19 [ "pii" => "S234119291930054X" "issn" => "23411929" "doi" => "10.1016/j.redare.2018.12.007" "estado" => "S300" "fechaPublicacion" => "2019-04-01" "aid" => "999" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2019;66:206-12" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:13 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "European Diploma in Anaesthesiology and Intensive Care in Spain: Results for the part 1 and part 2 exams in the last five years. Are we going in the right direction?" 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Brogly, W. Engelhardt, S. Hill, E.-M. Ringvold, A. Varosyan, A. Varvinskiy, M. Zerafa" "autores" => array:7 [ 0 => array:2 [ "nombre" => "N." "apellidos" => "Brogly" ] 1 => array:2 [ "nombre" => "W." "apellidos" => "Engelhardt" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Hill" ] 3 => array:2 [ "nombre" => "E.-M." "apellidos" => "Ringvold" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Varosyan" ] 5 => array:2 [ "nombre" => "A." "apellidos" => "Varvinskiy" ] 6 => array:2 [ "nombre" => "M." "apellidos" => "Zerafa" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935618302469" "doi" => "10.1016/j.redar.2018.12.009" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935618302469?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S234119291930054X?idApp=UINPBA00004N" "url" => "/23411929/0000006600000004/v1_201904250611/S234119291930054X/v1_201904250611/en/main.assets" ] "itemAnterior" => array:19 [ "pii" => "S2341192919300472" "issn" => "23411929" "doi" => "10.1016/j.redare.2018.11.012" "estado" => "S300" "fechaPublicacion" => "2019-04-01" "aid" => "990" "copyright" => "Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor" "documento" => "article" "crossmark" => 1 "subdocumento" => "fla" "cita" => "Revista Española de Anestesiología y Reanimación (English Version). 2019;66:189-98" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "en" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "Perioperative factors that contribute to postoperative pain and/or nausea and vomiting in ambulatory laparoscopic surgery" "tienePdf" => "en" "tieneTextoCompleto" => "en" "tieneResumen" => array:2 [ 0 => "en" 1 => "es" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "189" "paginaFinal" => "198" ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "Factores perioperatorios que contribuyen a la aparición de dolor o náuseas y vómitos postoperatorios en cirugía laparoscópica ambulatoria" ] ] "contieneResumen" => array:2 [ "en" => true "es" => true ] "contieneTextoCompleto" => array:1 [ "en" => true ] "contienePdf" => array:1 [ "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J. López-Torres López, D. Piedracoba Cadahía, M.J. Alcántara Noalles, T. Simó Cortés, P. Argente Navarro" "autores" => array:5 [ 0 => array:2 [ "nombre" => "J." "apellidos" => "López-Torres López" ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Piedracoba Cadahía" ] 2 => array:2 [ "nombre" => "M.J." "apellidos" => "Alcántara Noalles" ] 3 => array:2 [ "nombre" => "T." "apellidos" => "Simó Cortés" ] 4 => array:2 [ "nombre" => "P." "apellidos" => "Argente Navarro" ] ] ] ] ] "idiomaDefecto" => "en" "Traduccion" => array:1 [ "es" => array:9 [ "pii" => "S0034935618302342" "doi" => "10.1016/j.redar.2018.11.007" "estado" => "S300" "subdocumento" => "" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0034935618302342?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2341192919300472?idApp=UINPBA00004N" "url" => "/23411929/0000006600000004/v1_201904250611/S2341192919300472/v1_201904250611/en/main.assets" ] "en" => array:20 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Original article</span>" "titulo" => "General or regional? Exploring patients’ anaesthetic preferences and perception of regional anaesthesia" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "199" "paginaFinal" => "205" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "J.S. Lavado, D. Gonçalves, L. Gonçalves, C. Sendino, E. Valente" "autores" => array:5 [ 0 => array:4 [ "nombre" => "J.S." "apellidos" => "Lavado" "email" => array:1 [ 0 => "joanasflavado@gmail.com" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "D." "apellidos" => "Gonçalves" ] 2 => array:2 [ "nombre" => "L." "apellidos" => "Gonçalves" ] 3 => array:2 [ "nombre" => "C." "apellidos" => "Sendino" ] 4 => array:2 [ "nombre" => "E." "apellidos" => "Valente" ] ] "afiliaciones" => array:1 [ 0 => array:2 [ "entidad" => "Departamento de Anestesiología, Centro Hospitalar de Leiria, Leiria, Portugal" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Corresponding author." ] ] ] ] "titulosAlternativos" => array:1 [ "es" => array:1 [ "titulo" => "¿General o regional? Preferencias anestésicas de los pacientes y su percepción sobre la anestesia regional" ] ] "resumenGrafico" => array:2 [ "original" => 0 "multimedia" => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1165 "Ancho" => 2358 "Tamanyo" => 108498 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patients’ level of anxiety with respect to undergoing anaesthesia and remaining awake during surgery.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Background and objectives</span><p id="par0005" class="elsevierStylePara elsevierViewall">Regional anaesthesia (RA) has gained popularity among anaesthesiologists thanks to its numerous benefits and good safety profile. However, patients often refuse this type of procedure, preferring general anaesthesia (GA). Since patient refusal is an absolute contraindication for RA, many patients fail to benefit from the advantages of this technique. It is essential to explore RA from the patient's perspective, since anaesthesiologists can only achieve their goals if they acknowledge their patient's concerns.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Many studies on this topic have been performed outside Europe, and may not reflect the cultural differences and concerns that may influence acceptance of RA. Some, moreover, were performed more than 10 years ago, and may not reflect the opinion of today's patients. In addition, no studies have hitherto questioned patients on their understanding of the benefits of RA.</p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study was to investigate the variables (demographic factors, patients’ fears, anxieties, and perception of GA and RA in terms of safety, risks and benefits) associated with patients’ anaesthetic preference (GA or RA). The ultimate objective was to identify surgery-specific factors, and thus increase patient confidence in and acceptance of RA.</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Methods</span><p id="par0020" class="elsevierStylePara elsevierViewall">A total of 102 patients were evaluated during a 3-month period (February–April 2017), prior to their pre-anaesthesia consultation. The patients were scheduled for surgery (general, orthopaedic, urological, ENT, ocular, or gynaecological) or interventions outside the operating room (mainly gastroenterological). The patients were enrolled before their pre-anaesthesia consultation by an anaesthesiologist member of the research team. All consecutive patients aged over 18 years that were able to give written informed consent were invited to participate in the study; only 1 patient refused. The study was approved by the Ethics Committee and the hospital's Board of Directors. Written informed consent was obtained from all patients. No patient dropped out of the study after signing the consent form.</p><p id="par0025" class="elsevierStylePara elsevierViewall">The patients completed a questionnaire in the waiting room, before their appointment with the anaesthesiologist, and before being offered a particular anaesthetic technique. The questionnaire (annexe, available in the online version of this article) was based on earlier studies and included a brief explanation of GA and RA to enable patients to understand the differences between these techniques.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1–5</span></a> The body of the questionnaire was divided into 3 parts: Part 1 contained demographic questions, Part 2 asked after the patient's previous experience with anaesthesia, and Part 3 explored the patient's anaesthesia preferences and perception of safety, and evaluated their knowledge of RA and their concerns with the technique. Questions relating to 7 benefits of RA were answered with a “yes” or “no”. In order to avoid erroneous information, all the sentences were true. The data were analysed using the Statistical Package for the Social Sciences (SPPS – version 22.0 for Windows) (IBM, USA). Descriptive statistics were used to summarise the data. The percentages reported were calculated from valid answers. To identify correlations between variables, the Student's <span class="elsevierStyleItalic">t</span> test was used for continuous and categorical variables; correlation analysis was used to test 2 continuous variables, and <span class="elsevierStyleItalic">χ</span><span class="elsevierStyleSup">2</span> statistics were used to test 2 categorical variables. Statistical significance was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05.</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Results</span><p id="par0030" class="elsevierStylePara elsevierViewall">The average age of the sample was 52.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13.5 years, 57.8% were women, and 44.5% had at least 12 years of education or a university degree. In terms of surgical specialty, 38.2% were scheduled for general surgery, 22.5% for orthopaedic surgery, 18.6% for gynaecological surgery, 3.9% for urological procedures, 2% for ocular surgery, and 4.9% were candidates for interventions outside the operating room.</p><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Previous experience with anaesthesia</span><p id="par0035" class="elsevierStylePara elsevierViewall">Analyzing previous experience with anaesthesia showed that 91.2% of patients had previously received anaesthesia, 59.8% had previously undergone GA, 37.3% had had spinal anaesthesia (SA) and 4.9% had had nerve blocks (NB).</p><p id="par0040" class="elsevierStylePara elsevierViewall">Of the 38 patients who had previously received SA, 8 (21%) stated that they had had complications (minor or major). Patients treated with NB did not report any complications. Only 4.4% stated that they knew someone who had had RA-related complications. Overall, the complications reported were sensory deficit in the legs, pain during surgery, urinary retention, nausea and vomiting, an allergic reaction, and a patient who had experienced paralysis and had “head” problems.</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Patients’ perspective of regional general anaesthesia</span><p id="par0045" class="elsevierStylePara elsevierViewall">Safety was rated from 1 (very safe) to 4 (very dangerous). Although patients generally tended to consider that GA was safer (mean 2.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.6) than RA (mean 2.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.7 for SA and 2.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.6 for NB), the differences were not significant. Sex was the only demographic characteristic that was significantly associated with a perception of RA being safer. More women perceived RA as being safer (mean<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.7 for SA and 2.5<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.6 for NB) than men (mean<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.7 for SA and 2.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.6 for NB, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.04 for SA and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02 for NB) No differences were found in the perception of GA safety between women and men. There was no correlation between education or age and perception of anaesthesia safety.</p><p id="par0050" class="elsevierStylePara elsevierViewall">Anxiety at the thought of anaesthesia, and specifically at the thought of remaining awake during surgery, was rated from 1 (very calm) and 5 (very nervous). Patients felt considerably more nervous about the thought of being awake during surgery than the thought of recieving general anaesthesia (mean<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.1 vs. 2.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.1, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01) (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>). Women were more anxious about anaesthesia than men (mean<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.1 vs. 2.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.02). There were no differences between sexes in terms of anxiety at the thought of being awake during surgery. Different levels of anxiety were not correlated with either age or educational level.</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">In Part 2 of the questionnaire, participants were presented with 8 possible negative episodes normally associated with RA. For each sentence, the patients were asked to rate: (a) their level of fear, and (b) the probability of each episode occurring under RA, as shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>. The episodes rated by most patients as more likely to occur also corresponded to those they most feared, namely, residual sensory alterations, pain during surgery, paraplegia and back pain. Fear was also highly correlated with the perceived probability of each episode (total <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01).</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Demographic factors correlated with specific fears of RA were: older age correlated with a greater fear of infection and sensory disturbances, and lower educational level correlated with fear of needles (<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.05). No differences were observed between the sexes in this part of the questionnaire.</p></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0090">Preference for general or regional anaesthesia</span><p id="par0065" class="elsevierStylePara elsevierViewall">In terms of choice, 54% of patients preferred GA over RA. Patients were asked to give their reasons for this in a free text field (spontaneous answer). The reasons were categorised later (<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>). Some (20.7%) patients would refuse RA if offered it by the anaesthesiologist, which corresponded with 39% of patients who preferred GA.</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Patients who preferred GA though it was safer than patients who preferred RA (mean<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>2.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.6 vs. 2.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>0.5, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.04). No correlation was observed between anaesthetic preference and perception of the safety of SA or NB.</p><p id="par0075" class="elsevierStylePara elsevierViewall">There was no correlation between general anxiety at the thought of anaesthesia and anaesthetic preference. However, patients who preferred GA over RA expressed greater anxiety at remaining awake during surgery (mean<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1 and 2.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1, respectively; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01).</p><p id="par0080" class="elsevierStylePara elsevierViewall">Patients that preferred GA over RA had a greater fear of needles (mean<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.2<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.4 vs. 2.3<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.2, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span><<span class="elsevierStyleHsp" style=""></span>0.01), pain during surgery (mean<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.2 and 2.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.3, respectively, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.01) and back pain after RA (mean<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>3.4<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.3 vs. 2.7<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>1.2, <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>0.04), as shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>. Anaesthesia preference was not correlated with demographic variables (age, sex or education).</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0095">Knowledge of regional anaesthesia</span><p id="par0085" class="elsevierStylePara elsevierViewall">Many patients were unaware of the benefits of RA listed in the questionnaire, as shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>.</p><p id="par0090" class="elsevierStylePara elsevierViewall">In terms of evaluating their knowledge, we speculated that a patient who answered “yes” to more questions (that is, who had greater knowledge of the benefits of RA) would consider RA to be a safer procedure and would, therefore, prefer it over GA. However, we did not find statistically significant correlations, either for the perceived safety of SA and NB, and the preference of RA over GA. Similarly, we found no correlation between the number of questions answered affirmatively and less fear of the technique.</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0100">Willingness to receive regional anaesthesia again</span><p id="par0095" class="elsevierStylePara elsevierViewall">Thirty-eight patients had previously received SA. Of these, 40% said they would not go through it again. The reasons for this were given spontaneously, and mainly concerned technical difficulties, sensory alterations, and anxiety at the likelihood of remaining awake during surgery, or of feeling pain during the intervention. One patient would not choose it again due to a recent diagnosis of multiple sclerosis.</p><p id="par0100" class="elsevierStylePara elsevierViewall">Only 5 patients had previously received NB, and of these 4 would be willing to repeat the procedure.</p></span></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0105">Discussion</span><p id="par0105" class="elsevierStylePara elsevierViewall">The results show that patients who preferred GA considered it to be a safer procedure than patients who preferred RA. This may be due to historical reasons, since GA was the most common technique several decades ago, and people tend to prefer the known over the unknown (mere-exposure effect). Previous studies also show patients’ preference for GA over RA.<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> However, patients that have previously received RA are less likely to prefer GA.<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2,3,6,7</span></a> In fact, preference for GA and RA was justified by previous positive experiences. This familiarity effect may also help to explain why women stated that RA was safer than AG, since epidural analgesia for childbirth is widely accepted as a safe technique in the country where this study was performed.</p><p id="par0110" class="elsevierStylePara elsevierViewall">The reasons for preferring GA over of RA were similar to those reported in previous studies, and mainly involved misgivings about RA and fear at the thought of being awake during the intervention.<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1–5</span></a> Patients who preferred GA over RA expressed greater fear of back pain, needles, and pain during the procedure. The fear of pain during surgery was also one of the spontaneous reasons given for preferring GA, and is also the situation most likely to occur, according to patients. This was surprising, since RA is considered the gold standard technique for pain management. Interestingly, patients who refused to repeat RA did not list “feeling pain” among their reasons, instead, they stated that they did not like the sensation of “feeling the surgery, or of being awake during the procedure”. Sedation may have improved the experience of these patients. In fact, patients who preferred GA reported more anxiety at the thought of being awake during surgery. Similarly, fear of being awake was the spontaneous answer given by 38.3% of patients to justify their preference for GA. However, it should be noted that some patients who preferred RA did so because they did not wish to lose consciousness. We could speculate that patients do not want to lose control of events in the operating room, or are afraid of revealing personal information while anaesthetised. Future studies could investigate this preference.</p><p id="par0115" class="elsevierStylePara elsevierViewall">Less than half (39%) of patients who preferred GA over RA stated that they would refuse RA if offered it by the anaesthesiologist (about one fifth of the total sample). This was surprisingly high, considering that in our country the patient-doctor relationship is paternalistic and patients tend to trust their doctor to choose the best for them. Exploring the factors that distinguish patients who refuse RA from those who merely express a preference for GA could be a subject for further research.</p><p id="par0120" class="elsevierStylePara elsevierViewall">Previous authors have stated that anaesthesiologists and patients may have different concerns about RA.<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">3,8</span></a> Indeed, anaesthesiologists are usually concerned about post dural puncture headache, vomiting, and infection (along with possible neurological complications), while these were the least of the patients’ fears. This could be because patients are aware that these complications are rare, or because they consider them to be minor effects that they have already experienced and from which they can recover without permanent damage. Instead, along with the fear of neurological damage, patients expressed concerns that are not included among the known complications associated with RA. It is essential to identify the differences between the concerns of the anaesthesiologist and those of the patient, since anaesthesiologist could underestimate some of these concerns, and not discuss them when suggesting RA.</p><p id="par0125" class="elsevierStylePara elsevierViewall">Other authors have investigated patients’ concerns about neurological damage after RA. However, the patient's perception of the likelihood of each possible complication occurring has not been explored. In our study, we observed a discrepancy between patients’ perception and the actual incidence of complications. While 21.9% of patients thought there was a high probability of becoming paraplegic, 27.9% of suffering from sensory alterations, and 23.9% of presenting back pain, the real probability of suffering neurological damage is much lower. According to the Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anaesthesia and Pain Medicine, the incidence of neuroaxial injury for any reason in the general population is between 0.001 and 0.07%, and the incidence of NB-related neuroaxial injury is between 0.02% and 0.04%.<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> Similarly, back pain can be caused by various factors, such as positioning or duration of surgery, and its incidence does not vary between GA and RA.<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Patient perceptions could be influenced by third hand reports and stories.</p><p id="par0130" class="elsevierStylePara elsevierViewall">The lack of promotion of RA in the general public was evidenced by the patient's ignorance of its benefits. The percentage of patients who were familiar with each benefit ranged from 25.6% to 39.7%. Explaining the benefits of RA and discussing patients’ concerns can sometimes be difficult due to time restrictions during the pre-anaesthesia consultation. Moreover, it is difficult to emphasise the value of this technique. This task would be made easier by raising public awareness of RA<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">8,11</span></a> through different communications channels, such as health centres, the media and the Internet, using plain language. Surgeons can also help anaesthesiologists in this regard, since the preferences of the former may affect the patient's choice of anaesthesia,<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">7</span></a> and many patients discuss anaesthesia options with their surgeon before speaking with the anaesthesiologist.</p><p id="par0135" class="elsevierStylePara elsevierViewall">This study had certain limitations. The sample was small, and few patients had received NB; this prevented us from performed certain statistical tests. Previous experience with anaesthesia was evaluated on the basis of the patient's recollection of their medical history, which could have introduced memory bias. However, collecting information from medical reports could also have introduced bias, since patients could have undergone anaesthesia in different hospitals, or many years ago, and reports of the procedure could be difficult to access, or even entirely missing. Be that as it may, the aim of this study was to identify perceptions and subjective opinions of RA that could mainly have been influenced by the patient's recollection of previous experiences. For this reason, memory bias is less relevant in this study than in more objective studies.</p><p id="par0140" class="elsevierStylePara elsevierViewall">The fact that some patients (4.9%) were scheduled for surgical specialties in which RA was not an option could have influenced the results. Nevertheless, eliminating these participants from the sample did not significantly alter the results. As the questionnaire was completed before the pre-anaesthesia consultation, the patients did not know for certain what type of anaesthesia would be suggested, thereby minimising this effect. Although the aim of this study was to assess the patient's perspective before their appointment with the anaesthesiologist, an interesting topic for future research would be to evaluate how patients’ beliefs about RA change after consultation with the anaesthesiologist.</p><p id="par0145" class="elsevierStylePara elsevierViewall">In conclusion, the fear of remaining awake during surgery seems to be one of the main factors determining patients’ preference for GA over RA, together with their opinions on the safety of anaesthetic procedures, and the fear of RA. Patients are not aware of the real risks and benefits of RA. This shows that anaesthesiologists must continue their efforts to educate patients in order to achieve a more positive perception of RA.</p></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0110">Funding</span><p id="par0150" class="elsevierStylePara elsevierViewall">This study has not received subsidies from financial agencies in the public or commercial sectors.</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0115">Conflicts of interest</span><p id="par0155" class="elsevierStylePara elsevierViewall">The authors declare that they have no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:11 [ 0 => array:3 [ "identificador" => "xres1183069" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec1103657" "titulo" => "Keywords" ] 2 => array:3 [ "identificador" => "xres1183068" "titulo" => "Resumen" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec1103656" "titulo" => "Palabras clave" ] 4 => array:2 [ "identificador" => "sec0005" "titulo" => "Background and objectives" ] 5 => array:2 [ "identificador" => "sec0010" "titulo" => "Methods" ] 6 => array:3 [ "identificador" => "sec0015" "titulo" => "Results" "secciones" => array:5 [ 0 => array:2 [ "identificador" => "sec0020" "titulo" => "Previous experience with anaesthesia" ] 1 => array:2 [ "identificador" => "sec0025" "titulo" => "Patients’ perspective of regional general anaesthesia" ] 2 => array:2 [ "identificador" => "sec0030" "titulo" => "Preference for general or regional anaesthesia" ] 3 => array:2 [ "identificador" => "sec0035" "titulo" => "Knowledge of regional anaesthesia" ] 4 => array:2 [ "identificador" => "sec0040" "titulo" => "Willingness to receive regional anaesthesia again" ] ] ] 7 => array:2 [ "identificador" => "sec0045" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "sec0050" "titulo" => "Funding" ] 9 => array:2 [ "identificador" => "sec0055" "titulo" => "Conflicts of interest" ] 10 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2018-05-31" "fechaAceptado" => "2018-12-02" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Keywords" "identificador" => "xpalclavsec1103657" "palabras" => array:5 [ 0 => "Regional anaesthesia" 1 => "General anaesthesia" 2 => "Fear" 3 => "Knowledge" 4 => "Patient preference" ] ] ] "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec1103656" "palabras" => array:5 [ 0 => "Anestesia regional" 1 => "Anestesia general" 2 => "Miedos" 3 => "Conocimiento" 4 => "Preferencias de los pacientes" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introduction and objectives</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Regional anaesthesia (RA) has gained popularity due to its numerous benefits and increasing safety. Yet, often patients refuse this procedure and prefer general anaesthesia (GA). This study aimed to investigate variables (demographic factors, safety perception of GA and RA, patients’ fears, anxiety, and knowledge) related to patients’ anaesthetic preference.</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material and methods</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Participants were patients aged 18 years or more proposed to an anaesthesia appointment for preoperative assessment. Patients completed a written questionnaire before meeting the anaesthesiologist. The questionnaire asked about their preferences, fears and perceptions about RA.</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Results</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">One hundred and 2 patients agreed to participate. Mean age was 52.6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13.5 years, 57.8% were female and 44.5% had at least 12 years of education. Given the choice, 54.0% would prefer GA and 20.7% said they would refuse RA if proposed by the anaesthesiologist. Among patients who already experienced neuroaxial anaesthesia, 40.0% said they did not wish to repeat it. Patients who preferred GA over RA perceived GA to be safer than RA and expressed more anxiety towards being awake during surgery and more fear of feeling pain during surgery, of having back pain, and of needle puncture. Results also suggested that patients are unaware of RA's real risks and benefits.</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Knowing patients’ fears is essential for the anaesthesiologist address their patients’ needs. Anaesthesiologists should work on improving general population perspective and knowledge about RA.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0005" "titulo" => "Introduction and objectives" ] 1 => array:2 [ "identificador" => "abst0010" "titulo" => "Material and methods" ] 2 => array:2 [ "identificador" => "abst0015" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abst0020" "titulo" => "Conclusions" ] ] ] "es" => array:3 [ "titulo" => "Resumen" "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introducción y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La anestesia regional (AR) ha ganado popularidad debido a sus beneficios y su seguridad. Sin embargo, muchos pacientes rechazan la AR en favor de la anestesia general (AG). Este estudio investiga las variables (factores demográficos, percepción de seguridad, miedos y conocimientos sobre la AR) relacionadas con las preferencias anestésicas de los pacientes.</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y métodos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Los participantes eran mayores de 18 años, propuestos para una consulta anestésica. Rellenaron un cuestionario previamente a su cita.</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Resultados</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Ciento dos pacientes accedieron a participar. La media de edad era de 52,6<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>13,5 años. El 57,8% eran mujeres y el 44,5% contaba al menos con 12 años de estudios. Dados a elegir, el 54% prefería AG y el 20,7% rechazaba AR en caso de que se lo propusiera el anestesiólogo. Entre los pacientes que ya habían experimentado anestesia neuroaxial, el 40% no quería repetirlo. Los pacientes que preferían AG en lugar de AR la percibían como más segura y expresaban mayor ansiedad por permanecer despiertos durante la cirugía. Estos fueron también los que tenían mayor temor al pinchazo, al dolor de espalda y a sentir dolor durante la cirugía. Los resultados indican que los pacientes no conocían los verdaderos riesgos y beneficios de la AR.</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusiones</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">El conocimiento de los temores de los pacientes es esencial y ayudará a los anestesiólogos a satisfacer las necesidades de sus pacientes. Los anestesiólogos deben esforzarse en mejorar las perspectivas de la población y su conocimiento sobre la RA.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abst0025" "titulo" => "Introducción y objetivos" ] 1 => array:2 [ "identificador" => "abst0030" "titulo" => "Material y métodos" ] 2 => array:2 [ "identificador" => "abst0035" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "abst0040" "titulo" => "Conclusiones" ] ] ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Lavado JS, Gonçalves D, Gonçalves L, Sendino C, Valente E. ¿General o regional? Preferencias anestésicas de los pacientes y su percepción sobre la anestesia regional. Rev Esp Anestesiol Reanim. 2019;66:199–205.</p>" ] ] "multimedia" => array:4 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 1165 "Ancho" => 2358 "Tamanyo" => 108498 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patients’ level of anxiety with respect to undergoing anaesthesia and remaining awake during surgery.</p>" ] ] 1 => array:8 [ "identificador" => "tbl0005" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at1" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">If you had to receive regional anaesthesia, how would you rate your fear of...?: (1, not at all afraid; 5, very afraid)</th><th class="td" title="table-head " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">In your opinion, what is the probability of these episodes occurring with regional anaesthesia?: (1, very unlikely; 5, highly likely)</th></tr><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">1–2 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">3 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">4–5 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">1–2 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">3 \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">4–5 \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Becoming paralysed \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">21.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Headache \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">50.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">16.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">59.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Vomiting \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">52.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">15.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">49.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">14.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Pain during surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">29.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">41.1% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">35.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Difficulties in inserting the needle \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">24.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">44.9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34.8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">20.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Sensory alterations (e.g., leg/arm) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">48.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">27.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Back pain after regional anaesthesia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">28.2% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">33.3% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.4% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">36.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">23.9% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Puncture site infection \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">43.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">58.9% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">30.8% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">10.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2016393.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Distribution of patients level of fear and their estimate of the likelihood regional anaesthesia-related complications.</p>" ] ] 2 => array:8 [ "identificador" => "tbl0010" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at2" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Reason for preference \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="" valign="top" scope="col" style="border-bottom: 2px solid black"> \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " rowspan="8" align="left" valign="top">General anaesthesia</td><td class="td" title="table-entry " align="left" valign="top">Prefer to be asleep \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Back problems \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous positive experience \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">4.2% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">General anaesthesia is safer/better \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fear of feeling pain \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">6.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Due to the type of surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">It's better for the surgeon \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.1% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Do not know or do not provide explain preference \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">34% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " rowspan="6" align="left" valign="top">Regional anaesthesia</td><td class="td" title="table-entry " align="left" valign="top">Prefer to be awake \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">17.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Faster recovery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Safer than general anaesthesia \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">22.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Previous positive experience \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">12.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Due to the type of surgery \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">2.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Do not know or do not explain preference \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">40% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2016392.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Reasons for anaesthesia preference.</p>" ] ] 3 => array:8 [ "identificador" => "tbl0015" "etiqueta" => "Table 3" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "detalles" => array:1 [ 0 => array:3 [ "identificador" => "at3" "detalle" => "Table " "rol" => "short" ] ] "tabla" => array:1 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Did you know that with regional anaesthesia... \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Yes \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">No \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Is it easier to control postoperative pain? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">There is less risk of thrombosis? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">25.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">74.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Fewer drugs are needed to control pain? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">There is less risk of pulmonary complications? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">31.6% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">68.4% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">There is less risk of cardiac complications? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">39.7% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">60.3% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">Intestinal function is restored more rapidly? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">38% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">62% \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="table-entry ; entry_with_role_rowhead " align="left" valign="top">There is less risk of bleeding or the need for blood transfusion (depending on the intervention)? \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">32.5% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="char" valign="top">67.5% \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab2016391.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Patients’ awareness of the benefits of regional anaesthesia.</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:11 [ 0 => array:3 [ "identificador" => "bib0060" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "A survey of 800 patients’ knowledge, attitudes and concerns regarding anesthesia" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "K. 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