Anesthesia-related care dissatisfaction: a cohort historical study to reveal related risks

BACKGROUND: Most previous reports have used questionnaires to investigate patient satisfaction regarding anesthesia-related care. We retrospectively investigated the dissatisfaction rate for anesthesia and the contributing factors for it using a questionnaire including anesthesia-related adverse events and a simplified patient satisfaction scale. METHODS: This is a retrospective review of an institutional registry containing 21,606 anesthesia cases. We conducted multivariate logistic analysis in 9,429 patients using the incidence of dissatisfaction as a dependent variable and other covariates, including items of anesthesia registry and a postoperative questionnaire, as independent variables to investigate factors significantly associated with the risk of dissatisfaction with anesthesia. RESULTS: In the study population, 549 patients rated the anesthesia service as dissatisfactory. Multivariate analysis identified the preoperative presence of coexisting disease [odds ratio (OR), 1.29; 95% confidence interval (CI), 1.05–1.59], combination of regional anesthesia (OR, 1.44; 95% CI, 1.10–1.88), self-reported awareness (OR, 1.99; 95% CI, 1.29–3.06), postoperative nausea and vomiting (PONV) (OR, 1.54; 95% CI, 1.25–1.90), occurrence of nightmares (OR, 1.96; 95% CI, 1.52–2.53), and the number of days taken to visit a postoperative anesthesia consultation clinic (OR, 1.01; 95% CI, 1.00–1.02) to be independently associated with dissatisfaction with anesthesia service. CONCLUSIONS: Patients with coexisting disease, undergoing a combination of regional anesthesia, with self-reported awareness, experiencing PONV, suffering from nightmares, and who took longer to visit a postoperative anesthesia consultation clinic tended to rate our anesthesia service as dissatisfactory. Although the exact reasons for the factors contributing to dissatisfaction are unknown, this study suggests that there is room to improve our service.