Korean J Anesthesiol.
2023 Aug;76(4):280-289. 10.4097/kja.22624.
Effect of patient decision aids on choice between sugammadex and neostigmine in surgeries under general anesthesia: a multicenter randomized controlled trial
- Wang LK
1,2 - Lin YT1,2
- Chen JT3,4
- Lan W5
- Hung KC1,2
- Chen JY1
- Liu KJ3
- Yen YC6
- Chou YY7
- Cherng YG3,4
- Tam KW7,8,9,10
- Affiliations
-
- 1Department of Anesthesiology, Chi Mei Medical Center, Tainan, Taiwan
- 2Department of Hospital and Health Care Administration, College of Recreation and Health Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan
- 3Department of Anesthesiology, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- 4Department of Anesthesiology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- 5Department of General Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- 6Biostatistics Center, Office of Data Science, Taipei Medical University, Taipei, Taiwan
- 7Shared Decision Making Resource Center, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- 8Division of General Surgery, Department of Surgery, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan
- 9Cochrane Taiwan, Taipei Medical University, Taipei, Taiwan
- 10Division of General Surgery, Department of Surgery, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- KMID: 2544547
- DOI: http://doi.org/10.4097/kja.22624
Abstract
- Background
Shared decision making using patient decision aids (PtDAs) was established over a decade ago, but few studies have evaluated its efficacy in Asian countries. We therefore evaluated the application of PtDAs in a decision conflict between two muscle relaxant reversal agents, neostigmine and sugammadex, and sequentially analyzed the regional differences and operating room turnover rates.
Methods
This multicenter, outcome-assessor-blind, randomized controlled trial included 3,132 surgical patients from two medical centers admitted between March 2020 and August 2020. The patients were randomly divided into the classical and PtDA groups for pre-anesthesia consultations. Their clinicodemographic characteristics were analyzed to identify variables influencing the choice of reversal agent. On the day of the pre-anesthesia consultation, the patients completed the four SURE scale (sure of myself, understand information, risk-benefit ratio, encouragement) screening items. The operating turnover rates were also evaluated using anesthesia records.
Results
Compared with the classical group, the PtDA group felt more confident about receiving sufficient medical information (P < 0.001), felt better informed about the advantages and disadvantages of the medications (P < 0.001), exhibited a superior understanding of the benefits and risks of their options (P < 0.001), and felt surer about their choice (P < 0.001). Moreover, the PtDA group had a significantly greater tendency to choose sugammadex over neostigmine (P < 0.001).
Conclusions
PtDA interventions in pre-anesthesia consultations provided surgical patients with clear knowledge and better support. PtDAs should be made available in other medical fields to enhance shared clinical decision-making.
- Full Text Links
-
- Actions
-
Cited
- CITED
-
- Close
- Share
-
- Similar articles
-
- The use of sugammadex in an infant with prolonged neuromuscular blockade - A case report -
- Comparison of postoperative pulmonary complications between sugammadex and neostigmine in lung cancer patients undergoing video-assisted thoracoscopic lobectomy: a prospective double-blinded randomized trial
- Relationship between first-twitch depression and train-of-four ratio during sugammadex reversal of rocuronium-induced neuromuscular blockade
- Sugammadex versus neostigmine reversal of moderate rocuronium-induced neuromuscular blockade in Korean patients
- Anaphylaxis induced by sugammadex and sugammadex-rocuronium complex -a case report-
