Which clinical anesthesia outcomes are important to avoid? the perspectiveof patients

Healthcare quality can be improved by eliciting patient preferences and cus tomizing care to meet the needs of the patient. The goal of this study was to quantify patients' preferences for postoperative anesthesia outcomes. On e hundred one patients in the preoperative clinic completed a written surve y. Patients were asked to rank (order) 10 possible postoperative outcomes f rom their most undesirable to their least undesirable outcome. Each outcome was described in simple language. Patients were also asked to distribute $ 100 among the 10 outcomes, proportionally more money being allocated to the more undesirable outcomes. The dollar allocations were used to determine t he relative value of each outcome. Rankings and relative value scores corre lated closely (r(2) = 0.69). Patients rated from most undesirable to least undesirable (in order): vomiting, gagging on the tracheal tube, incisional pain, nausea, recall without pain, residual weakness, shivering, sore throa t, and somnolence (F-test < 0.01). Implications: Although there is variabil ity in how patients rated postoperative outcomes, avoiding nausea/vomiting, incisional pain, and gagging on the endotracheal tube was a high priority for most patients. Whether clinicians can improve the quality of anesthesia by designing anesthesia regimens that most closely meet each individual pa tient's preferences for clinical outcomes deserves further study.