Decision aid and preference assessment of topical anesthesia for otolaryngology procedures

Laryngoscope Investigative Otolaryngology

article

Elliana K. DeVore MD¹  Stacey T. Gray MD¹  Molly N. Huston MD²  Phillip C. Song MD¹  Blake C. Alkire MD¹  Matthew R. Naunheim MD, MBA¹ 

[1] Department of Otolaryngology—Head and Neck Surgery;Department of Otolaryngology, Washington University in St. Louis

关键词: anesthetics;    local;    coronavirus;    COVID-19;    decision making;    shared;    patient preference;    SARS-CoV-2;    surveys and questionnaires;   

DOI  :  10.1002/lio2.604

学科分类：环境科学（综合）

来源: Wiley

【 摘 要 】

Objectives To determine preference patterns for topical anesthesia in patients undergoing endoscopy pre-coronavirus (2019 coronavirus disease [COVID-19]) pandemic and analyze outcomes based on preference, using a decision aid format. Methods A decision aid was developed with expert and patient input. New patients presenting to subspecialty clinics over a 2-month pre-COVID-19 period completed a pre-procedure survey about their priorities, then were asked to choose between topical oxymetazoline/lidocaine spray or none. A post-procedure outcome survey followed. Results Of 151 patients, 90.1% patients elected to have topical anesthesia. Top patient priorities were “I want the scope to be easy for the doctor” and “I want to be as comfortable as possible.” Patients who strongly wanted to avoid medication ( P  = .002) and bad taste ( P  = .003) were more likely to select no spray, whereas those who wanted to avoid pain received anesthetic ( P  = .011). According to the post-procedure assessment, 95.4% of patients were satisfied or strongly satisfied their choice, and this did not correlate with anesthetic vs none. Conclusions Patient preferences are easily elicited and correlate with treatment choices. Most patients chose to have topical anesthetic and were willing to tolerate side effects; however, both patients with and without topical anesthetic were satisfied with their choices. This decision aid can be used to optimize shared decision making in the otolaryngology clinic. Given the aerosolizing potential of both spray and no spray conditions, this insight may be consequential when devising office protocols for post-COVID-19 practice. Level of evidence II.

【 授权许可】

CC BY|CC BY-NC-ND