Patient Discomfort Just Before Induction: What Can the Anesthesiologist Do?

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  • SUZUKI Akihiro
    Department of Anesthesiology and Critical Care Medicine, Asahikawa Medical College

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  • 麻酔科医の果たすべき役割：周術期のニーズに応える麻酔　　患者のニーズに応える麻酔導入法

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Abstract

  What can the anesthesiologist do for the patient to minimize discomfort just before induction of general anesthesia? Two major concerns which may compromise patient satisfaction were studied. <br>  First, we compared the induction profile between intravenously administered propofol and tidal breathing induction with 5% sevoflurane and 66% nitrous oxide. Induction time was significantly longer in the Sevo group, however, complication, patient discomfort, and facial scale evaluated by attended nurse were not different from the Propofol group. Thus, sevoflurane induction can be a suitable option if a vein is difficult to access. <br>  Second, patient discomfort during epidural tube insertion under sedation with midazolam or fentanyl were compared. When midazolam was administered to achieve a Ramsay sedation score of IIIto IV, 90% of the patients forgot the epidural catheterization procedure itself, but were able to address pain or abnormal sensations. Therefore, midazolam should be chosen if the patient is anxious about the procedure.

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