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Original article
General or regional? Exploring patients’ anaesthetic preferences and perception of regional anaesthesia
¿General o regional? Preferencias anestésicas de los pacientes y su percepción sobre la anestesia regional
J.S. Lavado
Corresponding author
joanasflavado@gmail.com

Corresponding author.
, D. Gonçalves, L. Gonçalves, C. Sendino, E. Valente
Departamento de Anestesiología, Centro Hospitalar de Leiria, Leiria, Portugal
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    "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 &#40;RA&#41; has gained popularity among anaesthesiologists thanks to its numerous benefits and good safety profile&#46; However&#44; patients often refuse this type of procedure&#44; preferring general anaesthesia &#40;GA&#41;&#46; Since patient refusal is an absolute contraindication for RA&#44; many patients fail to benefit from the advantages of this technique&#46; It is essential to explore RA from the patient&#39;s perspective&#44; since anaesthesiologists can only achieve their goals if they acknowledge their patient&#39;s concerns&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Many studies on this topic have been performed outside Europe&#44; and may not reflect the cultural differences and concerns that may influence acceptance of RA&#46; Some&#44; moreover&#44; were performed more than 10 years ago&#44; and may not reflect the opinion of today&#39;s patients&#46; In addition&#44; no studies have hitherto questioned patients on their understanding of the benefits of RA&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">The aim of this study was to investigate the variables &#40;demographic factors&#44; patients&#8217; fears&#44; anxieties&#44; and perception of GA and RA in terms of safety&#44; risks and benefits&#41; associated with patients&#8217; anaesthetic preference &#40;GA or RA&#41;&#46; The ultimate objective was to identify surgery-specific factors&#44; and thus increase patient confidence in and acceptance of RA&#46;</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 &#40;February&#8211;April 2017&#41;&#44; prior to their pre-anaesthesia consultation&#46; The patients were scheduled for surgery &#40;general&#44; orthopaedic&#44; urological&#44; ENT&#44; ocular&#44; or gynaecological&#41; or interventions outside the operating room &#40;mainly gastroenterological&#41;&#46; The patients were enrolled before their pre-anaesthesia consultation by an anaesthesiologist member of the research team&#46; All consecutive patients aged over 18 years that were able to give written informed consent were invited to participate in the study&#59; only 1 patient refused&#46; The study was approved by the Ethics Committee and the hospital&#39;s Board of Directors&#46; Written informed consent was obtained from all patients&#46; No patient dropped out of the study after signing the consent form&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">The patients completed a questionnaire in the waiting room&#44; before their appointment with the anaesthesiologist&#44; and before being offered a particular anaesthetic technique&#46; The questionnaire &#40;annexe&#44; available in the online version of this article&#41; was based on earlier studies and included a brief explanation of GA and RA to enable patients to understand the differences between these techniques&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1&#8211;5</span></a> The body of the questionnaire was divided into 3 parts&#58; Part 1 contained demographic questions&#44; Part 2 asked after the patient&#39;s previous experience with anaesthesia&#44; and Part 3 explored the patient&#39;s anaesthesia preferences and perception of safety&#44; and evaluated their knowledge of RA and their concerns with the technique&#46; Questions relating to 7 benefits of RA were answered with a &#8220;yes&#8221; or &#8220;no&#8221;&#46; In order to avoid erroneous information&#44; all the sentences were true&#46; The data were analysed using the Statistical Package for the Social Sciences &#40;SPPS &#8211; version 22&#46;0 for Windows&#41; &#40;IBM&#44; USA&#41;&#46; Descriptive statistics were used to summarise the data&#46; The percentages reported were calculated from valid answers&#46; To identify correlations between variables&#44; the Student&#39;s <span class="elsevierStyleItalic">t</span> test was used for continuous and categorical variables&#59; correlation analysis was used to test 2 continuous variables&#44; and <span class="elsevierStyleItalic">&#967;</span><span class="elsevierStyleSup">2</span> statistics were used to test 2 categorical variables&#46; Statistical significance was set at <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#46;</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&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;5 years&#44; 57&#46;8&#37; were women&#44; and 44&#46;5&#37; had at least 12 years of education or a university degree&#46; In terms of surgical specialty&#44; 38&#46;2&#37; were scheduled for general surgery&#44; 22&#46;5&#37; for orthopaedic surgery&#44; 18&#46;6&#37; for gynaecological surgery&#44; 3&#46;9&#37; for urological procedures&#44; 2&#37; for ocular surgery&#44; and 4&#46;9&#37; were candidates for interventions outside the operating room&#46;</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&#46;2&#37; of patients had previously received anaesthesia&#44; 59&#46;8&#37; had previously undergone GA&#44; 37&#46;3&#37; had had spinal anaesthesia &#40;SA&#41; and 4&#46;9&#37; had had nerve blocks &#40;NB&#41;&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Of the 38 patients who had previously received SA&#44; 8 &#40;21&#37;&#41; stated that they had had complications &#40;minor or major&#41;&#46; Patients treated with NB did not report any complications&#46; Only 4&#46;4&#37; stated that they knew someone who had had RA-related complications&#46; Overall&#44; the complications reported were sensory deficit in the legs&#44; pain during surgery&#44; urinary retention&#44; nausea and vomiting&#44; an allergic reaction&#44; and a patient who had experienced paralysis and had &#8220;head&#8221; problems&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Patients&#8217; perspective of regional general anaesthesia</span><p id="par0045" class="elsevierStylePara elsevierViewall">Safety was rated from 1 &#40;very safe&#41; to 4 &#40;very dangerous&#41;&#46; Although patients generally tended to consider that GA was safer &#40;mean 2&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6&#41; than RA &#40;mean 2&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7 for SA and 2&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6 for NB&#41;&#44; the differences were not significant&#46; Sex was the only demographic characteristic that was significantly associated with a perception of RA being safer&#46; More women perceived RA as being safer &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7 for SA and 2&#46;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6 for NB&#41; than men &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;7 for SA and 2&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6 for NB&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04 for SA and <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02 for NB&#41; No differences were found in the perception of GA safety between women and men&#46; There was no correlation between education or age and perception of anaesthesia safety&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Anxiety at the thought of anaesthesia&#44; and specifically at the thought of remaining awake during surgery&#44; was rated from 1 &#40;very calm&#41; and 5 &#40;very nervous&#41;&#46; Patients felt considerably more nervous about the thought of being awake during surgery than the thought of recieving general anaesthesia &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;1 vs&#46; 2&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;1&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; Women were more anxious about anaesthesia than men &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;1 vs&#46; 2&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;02&#41;&#46; There were no differences between sexes in terms of anxiety at the thought of being awake during surgery&#46; Different levels of anxiety were not correlated with either age or educational level&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0055" class="elsevierStylePara elsevierViewall">In Part 2 of the questionnaire&#44; participants were presented with 8 possible negative episodes normally associated with RA&#46; For each sentence&#44; the patients were asked to rate&#58; &#40;a&#41; their level of fear&#44; and &#40;b&#41; the probability of each episode occurring under RA&#44; as shown in <a class="elsevierStyleCrossRef" href="#tbl0005">Table 1</a>&#46; The episodes rated by most patients as more likely to occur also corresponded to those they most feared&#44; namely&#44; residual sensory alterations&#44; pain during surgery&#44; paraplegia and back pain&#46; Fear was also highly correlated with the perceived probability of each episode &#40;total <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0060" class="elsevierStylePara elsevierViewall">Demographic factors correlated with specific fears of RA were&#58; older age correlated with a greater fear of infection and sensory disturbances&#44; and lower educational level correlated with fear of needles &#40;<span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;05&#41;&#46; No differences were observed between the sexes in this part of the questionnaire&#46;</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&#44; 54&#37; of patients preferred GA over RA&#46; Patients were asked to give their reasons for this in a free text field &#40;spontaneous answer&#41;&#46; The reasons were categorised later &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">Table 2</a>&#41;&#46; Some &#40;20&#46;7&#37;&#41; patients would refuse RA if offered it by the anaesthesiologist&#44; which corresponded with 39&#37; of patients who preferred GA&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">Patients who preferred GA though it was safer than patients who preferred RA &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>2&#46;1<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;6 vs&#46; 2&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>0&#46;5&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#46; No correlation was observed between anaesthetic preference and perception of the safety of SA or NB&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">There was no correlation between general anxiety at the thought of anaesthesia and anaesthetic preference&#46; However&#44; patients who preferred GA over RA expressed greater anxiety at remaining awake during surgery &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1 and 2&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#44; respectively&#59; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Patients that preferred GA over RA had a greater fear of needles &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;4 vs&#46; 2&#46;3<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41;&#44; pain during surgery &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2 and 2&#46;9<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;3&#44; respectively&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;01&#41; and back pain after RA &#40;mean<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>3&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;3 vs&#46; 2&#46;7<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>1&#46;2&#44; <span class="elsevierStyleItalic">p</span><span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#46;04&#41;&#44; as shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46; Anaesthesia preference was not correlated with demographic variables &#40;age&#44; sex or education&#41;&#46;</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&#44; as shown in <a class="elsevierStyleCrossRef" href="#tbl0015">Table 3</a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">In terms of evaluating their knowledge&#44; we speculated that a patient who answered &#8220;yes&#8221; to more questions &#40;that is&#44; who had greater knowledge of the benefits of RA&#41; would consider RA to be a safer procedure and would&#44; therefore&#44; prefer it over GA&#46; However&#44; we did not find statistically significant correlations&#44; either for the perceived safety of SA and NB&#44; and the preference of RA over GA&#46; Similarly&#44; we found no correlation between the number of questions answered affirmatively and less fear of the technique&#46;</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&#46; Of these&#44; 40&#37; said they would not go through it again&#46; The reasons for this were given spontaneously&#44; and mainly concerned technical difficulties&#44; sensory alterations&#44; and anxiety at the likelihood of remaining awake during surgery&#44; or of feeling pain during the intervention&#46; One patient would not choose it again due to a recent diagnosis of multiple sclerosis&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">Only 5 patients had previously received NB&#44; and of these 4 would be willing to repeat the procedure&#46;</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&#46; This may be due to historical reasons&#44; since GA was the most common technique several decades ago&#44; and people tend to prefer the known over the unknown &#40;mere-exposure effect&#41;&#46; Previous studies also show patients&#8217; preference for GA over RA&#46;<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">1</span></a> However&#44; patients that have previously received RA are less likely to prefer GA&#46;<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">2&#44;3&#44;6&#44;7</span></a> In fact&#44; preference for GA and RA was justified by previous positive experiences&#46; This familiarity effect may also help to explain why women stated that RA was safer than AG&#44; since epidural analgesia for childbirth is widely accepted as a safe technique in the country where this study was performed&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">The reasons for preferring GA over of RA were similar to those reported in previous studies&#44; and mainly involved misgivings about RA and fear at the thought of being awake during the intervention&#46;<a class="elsevierStyleCrossRefs" href="#bib0060"><span class="elsevierStyleSup">1&#8211;5</span></a> Patients who preferred GA over RA expressed greater fear of back pain&#44; needles&#44; and pain during the procedure&#46; The fear of pain during surgery was also one of the spontaneous reasons given for preferring GA&#44; and is also the situation most likely to occur&#44; according to patients&#46; This was surprising&#44; since RA is considered the gold standard technique for pain management&#46; Interestingly&#44; patients who refused to repeat RA did not list &#8220;feeling pain&#8221; among their reasons&#44; instead&#44; they stated that they did not like the sensation of &#8220;feeling the surgery&#44; or of being awake during the procedure&#8221;&#46; Sedation may have improved the experience of these patients&#46; In fact&#44; patients who preferred GA reported more anxiety at the thought of being awake during surgery&#46; Similarly&#44; fear of being awake was the spontaneous answer given by 38&#46;3&#37; of patients to justify their preference for GA&#46; However&#44; it should be noted that some patients who preferred RA did so because they did not wish to lose consciousness&#46; We could speculate that patients do not want to lose control of events in the operating room&#44; or are afraid of revealing personal information while anaesthetised&#46; Future studies could investigate this preference&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Less than half &#40;39&#37;&#41; of patients who preferred GA over RA stated that they would refuse RA if offered it by the anaesthesiologist &#40;about one fifth of the total sample&#41;&#46; This was surprisingly high&#44; considering that in our country the patient-doctor relationship is paternalistic and patients tend to trust their doctor to choose the best for them&#46; 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&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Previous authors have stated that anaesthesiologists and patients may have different concerns about RA&#46;<a class="elsevierStyleCrossRefs" href="#bib0070"><span class="elsevierStyleSup">3&#44;8</span></a> Indeed&#44; anaesthesiologists are usually concerned about post dural puncture headache&#44; vomiting&#44; and infection &#40;along with possible neurological complications&#41;&#44; while these were the least of the patients&#8217; fears&#46; This could be because patients are aware that these complications are rare&#44; or because they consider them to be minor effects that they have already experienced and from which they can recover without permanent damage&#46; Instead&#44; along with the fear of neurological damage&#44; patients expressed concerns that are not included among the known complications associated with RA&#46; It is essential to identify the differences between the concerns of the anaesthesiologist and those of the patient&#44; since anaesthesiologist could underestimate some of these concerns&#44; and not discuss them when suggesting RA&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Other authors have investigated patients&#8217; concerns about neurological damage after RA&#46; However&#44; the patient&#39;s perception of the likelihood of each possible complication occurring has not been explored&#46; In our study&#44; we observed a discrepancy between patients&#8217; perception and the actual incidence of complications&#46; While 21&#46;9&#37; of patients thought there was a high probability of becoming paraplegic&#44; 27&#46;9&#37; of suffering from sensory alterations&#44; and 23&#46;9&#37; of presenting back pain&#44; the real probability of suffering neurological damage is much lower&#46; According to the Second ASRA Practice Advisory on Neurologic Complications Associated With Regional Anaesthesia and Pain Medicine&#44; the incidence of neuroaxial injury for any reason in the general population is between 0&#46;001 and 0&#46;07&#37;&#44; and the incidence of NB-related neuroaxial injury is between 0&#46;02&#37; and 0&#46;04&#37;&#46;<a class="elsevierStyleCrossRef" href="#bib0100"><span class="elsevierStyleSup">9</span></a> Similarly&#44; back pain can be caused by various factors&#44; such as positioning or duration of surgery&#44; and its incidence does not vary between GA and RA&#46;<a class="elsevierStyleCrossRef" href="#bib0105"><span class="elsevierStyleSup">10</span></a> Patient perceptions could be influenced by third hand reports and stories&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">The lack of promotion of RA in the general public was evidenced by the patient&#39;s ignorance of its benefits&#46; The percentage of patients who were familiar with each benefit ranged from 25&#46;6&#37; to 39&#46;7&#37;&#46; Explaining the benefits of RA and discussing patients&#8217; concerns can sometimes be difficult due to time restrictions during the pre-anaesthesia consultation&#46; Moreover&#44; it is difficult to emphasise the value of this technique&#46; This task would be made easier by raising public awareness of RA<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">8&#44;11</span></a> through different communications channels&#44; such as health centres&#44; the media and the Internet&#44; using plain language&#46; Surgeons can also help anaesthesiologists in this regard&#44; since the preferences of the former may affect the patient&#39;s choice of anaesthesia&#44;<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&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">This study had certain limitations&#46; The sample was small&#44; and few patients had received NB&#59; this prevented us from performed certain statistical tests&#46; Previous experience with anaesthesia was evaluated on the basis of the patient&#39;s recollection of their medical history&#44; which could have introduced memory bias&#46; However&#44; collecting information from medical reports could also have introduced bias&#44; since patients could have undergone anaesthesia in different hospitals&#44; or many years ago&#44; and reports of the procedure could be difficult to access&#44; or even entirely missing&#46; Be that as it may&#44; the aim of this study was to identify perceptions and subjective opinions of RA that could mainly have been influenced by the patient&#39;s recollection of previous experiences&#46; For this reason&#44; memory bias is less relevant in this study than in more objective studies&#46;</p><p id="par0140" class="elsevierStylePara elsevierViewall">The fact that some patients &#40;4&#46;9&#37;&#41; were scheduled for surgical specialties in which RA was not an option could have influenced the results&#46; Nevertheless&#44; eliminating these participants from the sample did not significantly alter the results&#46; As the questionnaire was completed before the pre-anaesthesia consultation&#44; the patients did not know for certain what type of anaesthesia would be suggested&#44; thereby minimising this effect&#46; Although the aim of this study was to assess the patient&#39;s perspective before their appointment with the anaesthesiologist&#44; an interesting topic for future research would be to evaluate how patients&#8217; beliefs about RA change after consultation with the anaesthesiologist&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">In conclusion&#44; the fear of remaining awake during surgery seems to be one of the main factors determining patients&#8217; preference for GA over RA&#44; together with their opinions on the safety of anaesthetic procedures&#44; and the fear of RA&#46; Patients are not aware of the real risks and benefits of RA&#46; This shows that anaesthesiologists must continue their efforts to educate patients in order to achieve a more positive perception of RA&#46;</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&#46;</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&#46;</p></span></span>"
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      "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 &#40;RA&#41; has gained popularity due to its numerous benefits and increasing safety&#46; Yet&#44; often patients refuse this procedure and prefer general anaesthesia &#40;GA&#41;&#46; This study aimed to investigate variables &#40;demographic factors&#44; safety perception of GA and RA&#44; patients&#8217; fears&#44; anxiety&#44; and knowledge&#41; related to patients&#8217; anaesthetic preference&#46;</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&#46; Patients completed a written questionnaire before meeting the anaesthesiologist&#46; The questionnaire asked about their preferences&#44; fears and perceptions about RA&#46;</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&#46; Mean age was 52&#46;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#46;5 years&#44; 57&#46;8&#37; were female and 44&#46;5&#37; had at least 12 years of education&#46; Given the choice&#44; 54&#46;0&#37; would prefer GA and 20&#46;7&#37; said they would refuse RA if proposed by the anaesthesiologist&#46; Among patients who already experienced neuroaxial anaesthesia&#44; 40&#46;0&#37; said they did not wish to repeat it&#46; 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&#44; of having back pain&#44; and of needle puncture&#46; Results also suggested that patients are unaware of RA&#39;s real risks and benefits&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusions</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Knowing patients&#8217; fears is essential for the anaesthesiologist address their patients&#8217; needs&#46; Anaesthesiologists should work on improving general population perspective and knowledge about RA&#46;</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">Introducci&#243;n y objetivos</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">La anestesia regional &#40;AR&#41; ha ganado popularidad debido a sus beneficios y su seguridad&#46; Sin embargo&#44; muchos pacientes rechazan la AR en favor de la anestesia general &#40;AG&#41;&#46; Este estudio investiga las variables &#40;factores demogr&#225;ficos&#44; percepci&#243;n de seguridad&#44; miedos y conocimientos sobre la AR&#41; relacionadas con las preferencias anest&#233;sicas de los pacientes&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material y m&#233;todos</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Los participantes eran mayores de 18 a&#241;os&#44; propuestos para una consulta anest&#233;sica&#46; Rellenaron un cuestionario previamente a su cita&#46;</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&#46; La media de edad era de 52&#44;6<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>13&#44;5 a&#241;os&#46; El 57&#44;8&#37; eran mujeres y el 44&#44;5&#37; contaba al menos con 12 a&#241;os de estudios&#46; Dados a elegir&#44; el 54&#37; prefer&#237;a AG y el 20&#44;7&#37; rechazaba AR en caso de que se lo propusiera el anestesi&#243;logo&#46; Entre los pacientes que ya hab&#237;an experimentado anestesia neuroaxial&#44; el 40&#37; no quer&#237;a repetirlo&#46; Los pacientes que prefer&#237;an AG en lugar de AR la percib&#237;an como m&#225;s segura y expresaban mayor ansiedad por permanecer despiertos durante la cirug&#237;a&#46; Estos fueron tambi&#233;n los que ten&#237;an mayor temor al pinchazo&#44; al dolor de espalda y a sentir dolor durante la cirug&#237;a&#46; Los resultados indican que los pacientes no conoc&#237;an los verdaderos riesgos y beneficios de la AR&#46;</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 ayudar&#225; a los anestesi&#243;logos a satisfacer las necesidades de sus pacientes&#46; Los anestesi&#243;logos deben esforzarse en mejorar las perspectivas de la poblaci&#243;n y su conocimiento sobre la RA&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0025"
            "titulo" => "Introducci&#243;n y objetivos"
          ]
          1 => array:2 [
            "identificador" => "abst0030"
            "titulo" => "Material y m&#233;todos"
          ]
          2 => array:2 [
            "identificador" => "abst0035"
            "titulo" => "Resultados"
          ]
          3 => array:2 [
            "identificador" => "abst0040"
            "titulo" => "Conclusiones"
          ]
        ]
      ]
    ]
    "NotaPie" => array:1 [
      0 => array:2 [
        "etiqueta" => "&#9734;"
        "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as&#58; Lavado JS&#44; Gon&#231;alves D&#44; Gon&#231;alves L&#44; Sendino C&#44; Valente E&#46; &#191;General o regional&#63; Preferencias anest&#233;sicas de los pacientes y su percepci&#243;n sobre la anestesia regional&#46; Rev Esp Anestesiol Reanim&#46; 2019&#59;66&#58;199&#8211;205&#46;</p>"
      ]
    ]
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        "descripcion" => array:1 [
          "en" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Patients&#8217; level of anxiety with respect to undergoing anaesthesia and remaining awake during surgery&#46;</p>"
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                  <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">&nbsp;\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&#44; how would you rate your fear of&#46;&#46;&#46;&#63;&#58; &#40;1&#44; not at all afraid&#59; 5&#44; very afraid&#41;</th><th class="td" title="table-head  " colspan="3" align="left" valign="top" scope="col" style="border-bottom: 2px solid black">In your opinion&#44; what is the probability of these episodes occurring with regional anaesthesia&#63;&#58; &#40;1&#44; very unlikely&#59; 5&#44; highly likely&#41;</th></tr><tr title="table-row"><th class="td" title="table-head  " align="" valign="top" scope="col" style="border-bottom: 2px solid black">&nbsp;\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&#8211;2&nbsp;\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&nbsp;\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&#8211;5&nbsp;\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&#8211;2&nbsp;\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&nbsp;\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&#8211;5&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">21&#46;9&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">50&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">16&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">59&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;3&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">52&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">15&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">49&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">14&#46;1&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">29&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">41&#46;1&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">35&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;2&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">24&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">44&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">20&#46;3&#37;&nbsp;\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 &#40;e&#46;g&#46;&#44; leg&#47;arm&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">48&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">27&#46;9&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">28&#46;2&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">33&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#46;4&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">36&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">23&#46;9&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">43&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">25&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">58&#46;9&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">30&#46;8&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">10&#46;3&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "en" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Distribution of patients level of fear and their estimate of the likelihood regional anaesthesia-related complications&#46;</p>"
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                  <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">&nbsp;\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&nbsp;\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">&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#46;3&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;4&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">4&#46;2&#37;&nbsp;\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&#47;better&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;4&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">6&#46;4&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;1&#37;&nbsp;\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&#39;s better for the surgeon&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">2&#46;1&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">34&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">17&#46;5&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">5&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">22&#46;5&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">12&#46;5&#37;&nbsp;\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&nbsp;\t\t\t\t\t\t\n
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                  \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&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">40&#37;&nbsp;\t\t\t\t\t\t\n
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                  \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&#46;&#46;&#46;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#46;3&#37;&nbsp;\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&#63;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">74&#46;4&#37;&nbsp;\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&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#37;&nbsp;\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&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">31&#46;6&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">68&#46;4&#37;&nbsp;\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&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">39&#46;7&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">60&#46;3&#37;&nbsp;\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&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">38&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">62&#37;&nbsp;\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 &#40;depending on the intervention&#41;&#63;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">32&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="table-entry  " align="char" valign="top">67&#46;5&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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ISSN: 23411929
Original language: English
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es en pt

¿Es usted profesional sanitario apto para prescribir o dispensar medicamentos?

Are you a health professional able to prescribe or dispense drugs?

Você é um profissional de saúde habilitado a prescrever ou dispensar medicamentos