Surgeon–patient communication during awake procedures
Section snippets
Methods
Surgeons were recruited from the faculty of 2 Midwestern medical institutions—a university medical center and a university-affiliated hospital system. Using anesthesia billing records and recommendations from department administrators, we identified surgeons performing high volumes of awake or semiawake procedures (over 40 per year) in the departments of General Surgery, Orthopedic Surgery, Obstetrics and Gynecology, Plastic Surgery, Dermatology, Ophthalmology, Neurosurgery, Urology, and
Results
Of the 63 surgeons contacted, 33 agreed to participate and 23 were interviewed before conclusion of the study because of saturation. The interviews ranged from 7 to 57 minutes. Awake surgical procedures specifically referred to by surgeons during these interviews include excisional biopsy, vasectomy, first and second trimester abortion, angiogram, Mohs surgery, eyelid blepharoplasty, nipple reconstruction, cataract surgery (phacoemulsification), dialysis access, lumbar puncture and drain
Comments
In our study of surgeons' perceptions regarding awake procedures, we outline surgeons' views on awake procedures and collate their self-reported strategies for communication in this context. This initial, qualitative inquiry offers a broad, descriptive point of entry into surgeon perceptions and highlights areas worthy of further investigation. In particular, our findings highlight the tensions that exist between a surgeon's duty to care for the patient, efficiently manage the procedure room,
Acknowledgments
The authors thank Dr. Peter Angelos for mentorship and support. The authors also thank Colleen Kelly and Aubrey Jordan for technological contributions.
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2022, Oral OncologyCitation Excerpt :Therefore, the surgeon should address the patients’ discomfort, as well as pay attention to the technical aspects of the surgery during procedures under local anesthesia [36,37]. The circumstances mentioned above make tumor resection under local anesthesia more challenging than tumor resection under general anesthesia [30–32,35–41] and may explain the increased risk of positive and close surgical margins in resection of OSCC under local anesthesia. In this cohort, the rate of positive surgical margins following resection of OSCC was 33.0%, which is comparable with the reported rates in the literature [9,10,26,28,42,43].
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There were no relevant financial relationships or any sources of support in the form of grants, equipment, or drugs.
The authors declare no conflicts of interest.
This work was supported by the Bucksbaum Institute for Clinical Excellence at the University of Chicago, the Summer Research Program at the University of Chicago, and the Operative Performance Research Institute at the University of Chicago.