Video as a Patient Teaching Tool: Does It Add to the Preoperative Anesthetic Visit? Development and evaluation of a video program for presentation prior to elective cardiac surgery Preoperative Preparation Programs in Children: A Comparative Examination Structured preoperative patient education for patient-controlled analgesia. Preoperative anxiety and intraoperative anesthetic requirements. The Effect of Structured Preoperative Teaching On Patients' Use of Patient- Controlled Analgesia (PC A) And Their Management of Pain Reducing anxiety in parents before and during pediatric anesthesia induction. Preoperative psychological preparation for children undergoing ENT operations: a comparison of two methods. Anaesthesia Information—What Patients Want to Know Paediatric preoperative teaching: effects at induction and postoperatively. Videotape increases parental knowledge about pediatric pain management. Preoperative PCA teaching program to manage postoperative pain. The Use of a Video to Convey Preanesthetic Information to Patients Undergoing Ambulatory Surgery The effect of anesthetic patient education on preoperative patient anxiety. The Influence of Medical Information on the Perioperative Course of Stress in Cardiac Surgery Patients The effect of a preanaesthetic information booklet on patient understanding and satisfaction. Development and psychometric testing of a quality of recovery score after general anesthesia and surgery in adults. [Usefulness of an anesthesia information sheet before the preoperative visit]. Use of a preanesthetic video for facilitation of parental education and anxiolysis before pediatric ambulatory surgery. Preoperative education and outcome of patient controlled analgesia The Effects of Providing Preoperative Statistical Anaesthetic-Risk Information
M eeting the anesthesiologist is one of the surgical patient ’s highest priorities preoperatively ( l ) , and several reports document that this interaction reduces patient anxiety ( 2 - 4 ) . High anxiety may be associated with poorer surgical outcome ( 5 ) , whereas improved patient education is associated with increased patient satisfaction ( 6 ) and improved clinical outcome ( 7 ) . Video instruction may supplement conventional instruction techniques for general medical patients ( 8) and aid in obtaining informed consent ( 9 ) . No study has specifically evaluated an instructional video about anesthesia as a tool for educating surgical patients about their upcoming anesthetic and facilitating the anesthesiologist-patient relationship . The hypothesis of this study is that viewing an anesthesia preoperative video will improve patient knowledge and patient perception of the upcoming anesthetic and surgery compared to a st and ard preoperative interview without video instruction Background : The objective of the present study was to develop and evaluate the effects of a preparatory videotape on endocrine stress responses of patients prior to cardiac surgery and to analyze patient acceptance of this video for preoperative preparation We sought to determine whether an extensive behavioral preparation program for children undergoing surgery is more effective than a limited behavioral program . The primary end point was  child and parent anxiety during the preoperative period . Secondary end points included behavior of the child during the induction of anesthesia and the postoperative recovery period . Several days before surgery , children ( n = 75 ) aged 2 - 12 yr r and omly received either an information-based program ( OR tour ) , an information + modeling-based program ( OR tour + videotape ) , or an information + modeling + coping-based program ( OR tour + videotape + child-life preparation ) . Using behavioral and physiological measures of anxiety , we found that children who received the extensive program exhibited less anxiety immediately after the intervention , in the holding area on the day of surgery , and on separation to the operating room . These findings , however , achieved statistical significance only in the holding area on the day of surgery ( 44[10 - 72 ] vs 32[8 - 50 ] vs 9[6 - 33 ] ; P = 0.02 ) . Similarly , parents in the extensive program were significantly less anxious on the day of surgery in the preoperative holding area , as assessed by behavioral ( P = 0.015 ) and physiological measures ( P = 0.01 ) . In contrast , no differences were found among the groups during the induction of anesthesia , recovery room period , or 2 wk postoperatively . We conclude that children and parents who received the extensive preoperative preparation program exhibited lower levels of anxiety during the preoperative period , but not during the intraoperative or postoperative periods . Implication s : The extensive behavioral preoperative program that we undertook had limited anxiolytic effects . These effects were localized to the preoperative period and did not extended to the induction of anesthesia or the postoperative recovery period . ( Anesth Analg 1998;87:1249 - 55 STUDY OBJECTIVE To investigate the effectiveness of a structured preoperative education program in patients receiving patient-controlled analgesia ( PCA ) . DESIGN R and omized controlled trial . SETTING University-affiliated hospital . PATIENTS 60 ASA physical status I and II women undergoing major gynecologic surgery . INTERVENTIONS Patients were r and omly allocated to receive either st and ard information given during routine preanesthetic assessment ( n = 30 ) or additional structured preoperative education on the use of PCA ( n = 30 ) . MEASUREMENTS All patients received st and ard anesthesia and PCA was provided for postoperative analgesia . Patients were review ed bid by an independent team of pain specialists and nurses . Patient satisfaction , severity of postoperative pain , nausea , dizziness , and morphine consumption were measured at discharge from recovery room , 24 , and 48 hours after operation . Recovery characteristics of patients were also measured . MAIN RESULTS Pain scores and morphine consumption decreased over time ( p < 0.01 ) , but there was no significant difference between groups . The overall analgesic efficacy , side effects , and recovery times was not affected by the education program . Patient satisfaction in the education group was better than control during early recovery ( p= 0.03 ) , but there was no additional benefit in the remaining postoperative period . CONCLUSIONS Structured preoperative PCA education did not affect patient outcome . The early improvement in patient satisfaction was minimized by continued education and pain team supervision during the rest of the postoperative period UNLABELLED The purpose of this study was to determine whether larger doses of anesthetics are required in the anxious patient to establish and maintain a clinical ly sufficient hypnotic component of the anesthetic state . Fifty-seven women undergoing bilateral laparoscopic tubal ligation with a propofol-based anesthetic regimen  were enrolled in this cross-sectional study . Trait ( baseline ) and state ( situational ) anxiety were assessed in all patients immediately before surgery , and the propofol doses required for the induction and maintenance of anesthesia were recorded . A  bispectral index monitor was used to assure that the hypnotic component of the anesthetic state was the same in all patients . We found that patients with high trait anxiety required more propofol for both the induction ( 2.1+/-0.4 vs 1.8+/-0.3 mg/kg ; P = 0.01 ) and maintenance of anesthesia ( 170+/-70 vs 110+/-20 microg x kg(-1 ) x min(-1 ) ; P = 0.02 ) , compared with patients with low trait anxiety . State anxiety , however , was not found to affect the propofol doses required for the induction or maintenance of anesthesia . Multiple regression models confirmed that Trait anxiety is an independent predictor for intraoperative propofol requirements ( P = 0.02 ) . We conclude that increased baseline ( i.e. , trait ) anxiety is associated with increased intraoperative anesthetic requirements . Thus , we suggest that the initial dose of anesthetic administered by an anesthesiologist should be modified based on the anxiety level exhibited by the patient . IMPLICATION S The goal of this study was to assess the relationship between preoperative anxiety and intraoperative anesthetic requirements . We found that high baseline anxiety predicts increased intraoperative anesthetic requirements . We suggest that anesthesiologists should modify the initial induction dose based on the anxiety level exhibited by the patient This study examined the effect of structured preoperative teaching  on patients ' underst and ing of patient-controlled analgesia ( PCA ) and their management of pain . The experimental group received a written pamphlet and structured preoperative teaching on the use of PCA to manage their pain . The control group received the usual preoperative preparation normally provided by the physician . Both groups were later asked to complete a posttest to determine how well they understood the use of PCA  and how well they managed their pain . There was no statistically significant evidence that the experimental group 's knowledge of PCA  was different from that of the control group . However , there was significant evidence that the experimental group managed their pain better Fear and anxiety in a child undergoing surgery are correlated positively with the parent 's level of anxiety , and interventions to decrease the parent 's anxiety are appropriate . The purpose of this study was to determine whether viewing a video of an actual pediatric inhalation induction would reduce the level of parental anxiety . Eighty patients requiring an inhalation anesthetic induction were selected and r and omized to 2 groups . Parents in the experimental group ( group 1 ; n = 40 ) viewed a video demonstrating pediatric mask induction . Parents in the control group ( group 2 ; n = 40 ) received an information pamphlet only .  Anxiety was measured perioperatively in the parents and their children . Mean arterial pressure for children in group 1 was significantly lower during preoperative holding and following induction ( P < .05 ) . The level of anxiety postoperatively of children and parents in group 1 was significantly lower than that of children and parents in group 2 ( P < .05 ) . Viewing a preoperative video seems to be beneficial . Decreasing the parent 's level of anxiety preoperatively may have a positive effect on the child 's level of anxiety expressed postoperatively A psychological preparation programme was developed for outpatient surgery in children . The purpose of this study was to determine if the programme could increase retrieval of information and reduce anxiety prior to ENT surgery . After ethical committee approval , 160 children and their parents were included . Eighty children ( group 1 ) received conventional verbal information from an ENT nurse , and another 80 children ( group 2 ) received specific information , including role-play , from a nurse anaesthetist at a preadmission visit . Children 's and parents ' experience of premedication , operation theatre ( OR ) , i.v.-needle insertion and induction of anaesthesia were evaluated from a self-rating question naire . The question naire included ratings for anxiety and satisfaction with information and care . The results indicate a clear improvement of the preoperative acquisition of knowledge in all age groups . When it comes to alleviation of fear , a positive effect of the preparation programme was noticed , especially among the younger children ( < 5 years ) , while preoperative anxiety overall was a significantly smaller problem among the older children . The effects of the programme were also related to previous experience of anaesthesia and most beneficial among young children with such experience . Overall , the most negative procedure reported by the children was the i.m . injection for premedication ( a routine which was ab and oned as a result of the study ) , followed by the insertion of the i.v . -needle . The parents experienced watching their child fall asleep during induction of anaesthesia as most negative , followed by the insertion of the i.v.-needle . Parents also reported more satisfaction and less anxiety after having received specific information and preparation preoperatively . It was concluded that this preoperative preparation programme is useful in all age groups with regard to information , while alleviation of anxiety and fear was seen mainly among the younger children with previous experience of anaesthesia We developed and introduced into clinical practice a leaflet to improve the delivery of information to patients before obtaining their consent to anaesthesia . The amount of information needs to be what a “ reasonable ” patient thinks appropriate ; therefore we tested patients ’ responses to three levels of information : “ full ” disclosure , “ st and ard ” disclosure ( as contained in our leaflet ) and “ minimal ” disclosure .  Forty-five patients scheduled to undergo cardiac surgery were enrolled in the study . None of the information sheets caused a significant change in state anxiety score and only the “ full ” disclosure significantly increased knowledge about anaesthesia ( P=0.016 ) . All leaflets were easy to underst and . When only one leaflet was provided 64–73 % of patients thought the content was “ just right ” , whereas when all three leaflets were viewed together , 63 % of patients thought the “ minimal ” leaflet withheld too much information In a r and omized controlled trial at Duke University and University of North Carolina Hospitals , 143 two to six year old children undergoing elective ambulatory surgery were r and omized into a control group who received routine preoperative teaching or an intervention group who received an interactive teaching book .  Changes in behaviour were measured by a Vernon behavioural question naire preoperatively and again two weeks postoperatively . A Global Mood Score was assessed in the preoperative holding area , at arrival into the operating room , and at the time of mask induction . The children in the control group were significantly more aggressive postoperatively than the intervention group ( P < 0.05 ) . Children who received the interactive teaching book exhibited higher levels of anxiety on the day of surgery , but fewer behavioural changes two weeks following surgery . Parents in the intervention group reported that preoperative teaching helped their child ( 87 % ) and themselves ( 83 % ) UNLABELLED Pediatric pain management often depends on parents recognition and assessment of their child 's pain and their beliefs as to whether the pain should be treated . Parental misconceptions concerning pain assessment and pain management may therefore result in inadequate pain treatment , particularly in patients who are too young or too developmentally h and icapped to self-report their pain . We hypothesized that viewing a concise , educational videotape would provide parents with instructive information that could correct misconceptions concerning pain and pain management in children . To do this , we evaluated the impact of an educational videotape on parental responses to a question naire about pediatric pain management . Parents of children scheduled for inpatient , postoperative hospital care were studied . After answering 30 questions , parents were r and omly assigned to either view ( Group 1 ) or not view ( Group 2 ) a 19-min educational videotape . Immediately after viewing the videotape ( Group 1 ) , or 30 min after taking the first test ( Group 2 ) , parents were asked to answer the same question naire a second time . The effect of seeing the videotape was assessed by comparing post-pre test score differences using paired t-test . One-hundred parents were studied . R and omization was effective in assigning equitable groups . Initial scores of percent answers correct in each group were not different ( [ mean + /- SD ] Group 1 [ n = 50 ] : 68.7 % + /- 18.8 % vs Group 2 [ n = 50 ] : 61.5 % + /- 22.7 % ; P = 0.09 ) . Viewing the videotape effectively increased test scores : paired t-test within groups demonstrated a significant difference in Group 1 ( 22.4 % + /- 16.5 % , P < 0.0001 ) , whereas Group 2 scores changed to a much lesser degree ( 2.7 % + /- 8.3 % , P = 0.0271 ) . All parents who viewed the videotape stated that it was informative regarding their underst and ing of their child 's pain management . This study demonstrates the effectiveness of an educational videotape in changing parental knowledge concerning postoperative pediatric pain . This effective and efficient teaching medium may be useful in improving pain management in postoperative pediatric surgical patients . IMPLICATION S Pediatric pain management often depends on parents recognition and assessment of their child 's pain and their beliefs as to whether the pain should be treated . This prospect i ve , r and omized , controlled study demonstrated the effectiveness of an educational videotape in changing parental knowledge concerning postoperative pediatric pain . This effective and efficient teaching medium may be useful in preventing inadequate pain management in postoperative pediatric surgical patients Patient-controlled analgesia ( PCA ) therapy was design ed to provide patients with greater control in managing their pain . However , many patients continue to suffer from moderate to severe pain due to lack of knowledge about how to use PCA therapy . The results of this quasi-experimental study demonstrated that patients who received  structured preoperative teaching had statistically significant higher knowledge regarding the use of PCA therapy  and more positive attitudes toward using pain medicine .  Patients who received the video teaching reported better pain control and satisfaction with pain management 4 and 8 hours following their surgical procedures In a prospect i ve , r and omized , single-blind trial , we assessed the effectiveness of a preoperative video as a source of additional patient information before ambulatory surgery . One hundred twenty-seven patients were allocated to either treatment ( video ) or control ( nonvideo ) groups . Of the 127 , 17 ( 13 % ) patients correctly answered all process , risk , and misconception statements using a question naire . Overall , the video group was 2 - 16 times more likely to recall all knowledge questions correctly than the non-video group after adjusting for previous general anesthesia experience , state ( how one feels at the moment ) , and trait ( how one generally feels ) anxiety levels ( relative risk 6.36 , 95 % confidence interval 2.01 - 15.82 ) . The predictors of correct risk knowledge were those who had a video intervention ( relative risk 7.12 , 95 % confidence interval 3.70 to 10.07 ) and low trait anxiety scores ( relative risk 5.88 , 95 % confidence interval 1.69 to 25.00 ) . A video could be an important additional component of the preoperative interview , but anesthesiologists will still need to provide patient-specific information . Implication s : This study r and omly allocated adults to see a video about anesthesia  before scheduled ambulatory surgery . The video group had better recall of information . The video was a useful adjunct to routine preoperative consultations . ( Anesth Analg 1998;87:531 - 6 BACKGROUND AND OBJECTIVES Preoperative time spent with patients has been abbreviated with the advent of same-day admission requirements and outpatient surgery . This study was conducted to evaluate the effects that material s mailed to the home relating to anesthetic-focused patient education may have on preoperative patient anxiety . METHODS Patients scheduled for a total hip arthroplasty or for a total knee arthroplasty were screened via telephone for inclusion in a prospect i ve , r and omized study . Patients were asked about their access to a video cassette recorder/player ( VCR ) and their limitations regarding hearing or vision . Subjects were r and omly assigned to either the intervention group and received two pamphlets and a video describing general and regional anesthesia or to the usual care group . All subjects were mailed a preoperative demographic question naire and a State Trait Anxiety Inventory ( STAI ) , as developed by CD Spielberger . Question naires were completed at least 96 hours prior to admission and again preoperative on the day of surgery . RESULTS Of 236 patients screened , 26 had no access to a VCR , 6 were hearing or visually impaired , and 4 declined participation . Of 200 subjects r and omized , 134 completed both sets of question naires and thus form the basis of this report . A statistically significant difference between the subjects who received the video and pamphlets and the usual care subjects was detected with respect to change in STAI-assessed anxiety from baseline to immediately prior to surgery ( P = .035 ) . The intervention subjects experienced a smaller mean increase in anxiety . Forty-nine percent of the usual care subjects expressed interest in having additional information . CONCLUSIONS Increase in preoperative anxiety is diminished when additional anesthesia information in printed and video format is made available . Useful information can be provided to patients to view or read prior to surgery Cardiac surgery correlates with increased perioperative stress and anxiety .  We tested whether preoperative extensive oral information in combination with more personal attention by the surgeon is associated with any effect on  patients ’ perioperative stress , anxiety , and well-being .  Sixty patients awaiting open heart surgery were divided into two groups . Group I consisted of 30 patients who received routine medical information through an informative pamphlet . In Group II ( n = 30 patients ) , additional , extensive oral medical information and more personal attention by the surgeon was provided before surgery . Salivary cortisol , plasma cortisol , state anxiety , and patients ’ well-being were measured perioperatively . Extensive preoperative oral information in combination with more personal attention by the physician did not have any significant influence on the perioperative psychoendocrinologic course of stress . During transport to the operating room , salivary cortisol increased significantly ( P < 0.001 ) in both groups ( ranges are 95 % confidence intervals ) ( Group I , 23.2 nmol/L [ 17.1–31.5 ] ; Group II , 14.6 nmol/L [ 9.9–21.3 ] ) versus the first day in the hospital ( Group I , 8.4 nmol/L [ 6.2–11.4 ] ; Group II , 6.7 nmol/L [ 5.3–8.6 ] ) . After the induction of anesthesia , plasma cortisol decreased significantly ( P < 0.001 ) in both groups ( Group I , 170.1 nmol/L [ 143.6–201.4 ] ; Group II , 172.0 nmol/L [ 142.2–208.1 ] ) versus preoperative levels . After surgery , well-being decreased ( P = 0.003 ) in all patients , and patients ’ state anxiety was reduced ( P = 0.001 ) after surgery . Our data demonstrate a lack of effect of extensive oral medical information that was presented as part of clinical routine on the perioperative psychoendocrinologic course of stress . High levels of stress during transport to the operating room were detected AIM To determine if a brief user friendly anaesthetic booklet compliments the anaesthetic service currently provided , in terms of greater patient underst and ing and satisfaction . METHOD Two question naires were completed by participants in each group , one question naire preoperatively and the other postoperatively . The booklet group received the anaesthetic booklet in the mail with their booking card while the control group  only received their booking card . RESULTS Of the 209 eligible , 140 patients consented to and completed the preoperative question naire , of whom 53 were in the anaesthetic booklet group and 87 were in the control group . The postoperative question naire was completed by 38 and 65 respectively . The anaesthetic booklet group had better underst and ing of what a premed will do ( p < 0.05 ) and how long after an anaesthetic to wait before driving ( p < 0.025 ) . The percentage of correct answers for the more general anaesthetic questions was high and very similar in both groups . There was no significant difference in the satisfaction scores between groups . Satisfaction scores for both groups rose significantly in the postoperative question naire when compared with the preoperative question naire ( p < 0.001 ) . CONCLUSION The value of the anaesthetic booklet is in providing detailed anaesthetic information to the patient . This will aid the preanaesthetic consultation with the anaesthetist and provide a focus for further discussion about the intended anaesthetic . Patient satisfaction with the anaesthetic service was high in both groups pre- and postoperatively and was not altered by the anaesthetic booklet UNLABELLED A variety of methods have been used to quantify aspects of recovery after anesthesia . Most are narrowly focused , are not patient-rated , and have not been vali date d. We therefore set out to develop a patient-rated quality of recovery score . We constructed a 61-item question naire that asked individuals ( patients and relatives , medical and nursing staff ; total n = 136 ) to rate various postoperative items describing features a patient may experience postoperatively . The most highly ranked items were included in a final nine-point index score , which we called the " QoR Score . " We then studied two cohorts of surgical patients ( n = 449 ) . There was good convergent validity between the QoR Score and the visual analog scale score ( rho = 0.55 , P < 0.0001 ) . Discriminant construct validity was supported by comparing result ant QoR Scores in patients undergoing day-stay , minor , and major surgery ( P = 0.008 ) , as well as a negative correlation with duration of hospital stay ( rho = -0.20 , P < 0.0001 ) , and , using multivariate regression , demonstrating a significant negative relationship between QoR Score and female gender ( P = 0.048 ) and older age ( P = 0.041 ) . There was also good interrater agreement ( rho = 0.55 , P < 0.0001 ) , test-retest reliability ( median rho = 0.61 , P < 0.0001 ) , and internal consistency ( alpha = 0.57 and 0.90 , P < 0.0001 ) . There was a significant difference between the groups of patients recovering from major and minor surgery ( P < 0.001 ) . This study demonstrates that the QoR Score has good validity , reliability , and clinical acceptability in patients undergoing many types of surgery . IMPLICATION S We set out to develop a patient-rated quality of recovery score ( QoR ) that could be used both as a measure of outcome in perioperative trials and for clinical audit . We first surveyed patients and staff to identify important aspects of recovery , then developed a nine-point QoR Score . This was then compared with other measures of postoperative outcome . We found that the QoR Score is a useful measure of recovery after anesthesia and surgery OBJECTIVE The information patients receive about anesthesia in the preoperative period must be clear in order to assure their underst and ing and involvement in making decisions about proposed techniques . A sheet providing basic general information about anesthesia can prepare the patient for consultation with the anesthesiologist . PATIENTS AND METHODS A question naire with 14 yes/no questions was design ed for this prospect i ve , descriptive study . We surveyed 184 consecutive patients referred for preanesthetic assessment before elective surgery in a general hospital on the outskirts of Barcelona . RESULTS The information sheet was judged good and necessary for obtaining informed consent by between 96 and 97 % of the patients . A similar percentage judged the comprehensibility of the sheet to be good , although 15 % did not correctly answer questions about matters that were covered by the sheet . Anxiety increased after reading the sheet for 12 % , and 10 % even began to tremble . Additional clarification was requested by 9 % . CONCLUSIONS An information sheet improves comprehension of anesthetic procedures and facilitates informed consent . However , a need for further clarification is generated in a small proportion of patients and a substantial proportion believes the sheet caused greater fear . We therefore believe that information should be adapted to the particular requests and needs of individual patients UNLABELLED In this study , we evaluated the effects of viewing an educational videotape about pediatric anesthesia on measures of parental knowledge of anesthesia and preoperative anxiety using a r and omized , controlled design . During their routine preoperative visit , 85 parents of children scheduled to undergo ambulatory surgical procedures under general anesthesia were r and omized to view either the experimental videotape about pediatric anesthesia or a control videotape with no medical content . Before and immediately after viewing the assigned videotape , parents completed measures of situational anxiety ( State-Trait Anxiety Inventory-State ) , preoperative anxiety and need for information ( Amsterdam Preoperative Anxiety and Information Scale ) , and anesthesia knowledge ( St and ard Anesthesia Learning Test ) . Repeated- measures analyses of variance showed that parents who viewed the experimental videotape showed a significant increase in anesthesia knowledge ( P < 0.022 ) and a significant reduction in their state of anxiety ( P < 0.031 ) , anesthesia-specific anxiety , and need for information ( P < 0.0001 ) compared with the control group . These results demonstrated that viewing a preoperative educational videotape about pediatric anesthesia can provide immediate educational and anxiolytic benefits for parents of children undergoing ambulatory surgery . The duration of these benefits remains to be determined . IMPLICATION S In this study , we demonstrated the benefits of viewing an educational videotape about pediatric anesthesia on measures of parental knowledge of anesthesia and preoperative anxiety using a r and omized , controlled design . We found that videotape viewing facilitated preoperative preparation and lessened preoperative anxiety Purpose To determine the effect of intensive preoperative education on the outcome of  Patient Controlled Analgesia ( PCA ) postoperatively . Methods This prospect i ve r and omised study was carried out in a single teaching hospital over three months . One group of patients ( n = 42 ) received a 20 min st and ardised tutorial regarding PCA use from a single investigator and the other group ( n = 43 ) received no additional education apart from the routine preoperative anaesthetic consultation . A blinded investigator assessed the patients following surgery . Pain scores and morphine consumption , patient satisfaction , side-effect profile and anti-emetic use were recorded at six , 24 and 48 hr post-operatively . Results Pain scores , satisfaction scores and morphine consumption were similar in both groups throughout the study period . Fewer patients in the tutored group complained of nausea from 6 to 24 hr than did untutored patients ( 28%vs 51 % ; P < 0.05 ) . More tutored patients used antiemetic medication from 0 to 6 ( 28%vs 12%;P < 0.05 ) and 6 to 24 hr ( 37%vs 19%;P < 0.05 ) . Side effect profile and requirement for rescue analgesia was otherwise similar in both groups . Conclusion Our results suggest that specific preoperative education of patients using PCA  does not alter pain scores , morphine consumption or patient satisfaction but may result in earlier and more effective use of anti-emetic medication . RésuméObjectifDéterminer l’effet d’un enseignement préopératoire intensif sur l’évolution postopératoire de l’analgésie contrôlée par le patient (ACP).MéthodeOn a réalisé une étude prospect i ve et r and omisée dans un seul hôpital d’enseignement pendant trois mois . Un groupe de patients ( n = 42 ) a reçu d’un unique expérimentateur un cours individuel st and ardisé concernant l’utilisation de l’ACP et l’autre groupe ( n = 43 ) n’a reçu aucun enseignement additionnel après la visite de routine de l’anesthésiste avant l’intervention . Un expérimentateur impartial a évalué les patients après la chirurgie . Les scores de douleur et la consommation de morphine , la satisfaction du patient , le profil des effets secondaires et l’utilisation d’antiémétique ont été enregistrés six , 24 et 48 h après l’opération . RésultatLes scores de douleur et de satisfaction et la consommation de morphine étaient similaires dans les deux groupes tout au long de l’expérience . Il y a eu moins de plaintes de nausée entre 6 et 24 h chez les patients qui ont reçu un enseignement que chez ceux qui n’en ont pas eu ( 28 % vs 51 % ; P < 0,05 ) . Un plus gr and nombre de patients informés a utilisé des médicaments antiémétiques de 0 à 6 ( 28 % vs 12 % ; P < 0,05 ) et de 6 à 24 h ( 37 % vs 19 % ; P < 0,05 ) . Le profil des effets secondaires et la dem and e d’analgésie supplémentaire ont été , par ailleurs , similaires dans les deux groupes . Conclusion Nos résultats laissent croire qu’un enseignement préopératoire spécifique dispensé aux patients qui utilisent l’ACP n’a pas d’effet sur les scores de douleur , la consommation de morphine ou la satisfaction du patient , mais qu’il peut entraîner un usage précoce et plus efficace de médicaments antiémétiques Are patients who are provided with details about  anaesthesia risks on the eve of surgery better informed , and does the information increase their anxiety ? Forty ( ASA Class I or II ) patients scheduled for surgery requiring general anaesthesia were r and omly allocated to either a routine or a detailed information group .  Levels of anxiety were assessed by the Spielberger State-Trait Anxiety Inventory . Actual knowledge of risks was assessed by a special visual analogue scale .  Patients had experienced an average of five previous anaesthetics and so most patients in both groups knew the risks of common complications such as nausea and sore throat and were able to represent them accurately on the visual analogue scale . The detailed group , however , had gained more accurate knowledge of the likelihood of two rare complications , death ( P < 0.001 ) and serious tooth damage ( P < 0.05 ) . Notwithst and ing , there was no difference between the groups in anxiety . Thus , provision of detailed information about the risks of the complications of general anaesthesia did increase patients ’ knowledge but did not increase patients ’ levels of anxiety
UNLABELLED In this systematic review , we compared the effectiveness of media-based patient education  about  anesthesia .