Audiovisual Aid Pilot Study

Primary outcome will be number of skin conductance responses per second (SCR/sec) and amplitude of skin conductance responses averaged over time in 5 minute intervals and at key time points such before, during and after insertion of an IV, discussion with surgeon, anesthesiologist, immediately before leaving the holding area, immediately after entering the OR, during application of monitors, before and after administration of sedatives, before, during and after spinal insertion, incision, immediately prior to leaving the OR, after arrival at PACU and monitors are placed, before discharge from the PACU.

Time frame: Measured in 5 minute intervals, from holding area until PACU discharge.

Population: We had planned to use the Med-Storm Stress detector to measure skin conductance throughout the procedure until discharge. However, due to repeated technical difficulties with the device and inconclusive data from an analysis of a small number of patients data collection was stopped. No data are presented here.

The change in heart rate from holding area until PACU discharge.

Time frame: Measured from preop to postop

Population: Baseline has the heart rate number but analysis for intraop and postop is the change of the variable. Some patients were discharge earlier

The client satisfaction questionnaire (CSQ-8) is a standardized satisfaction measure and was used to collect patient feedback on the audio visual devices. Response options differ, but all are on a 4-point scale. Scores range from 8 to 32, with higher values indicating higher satisfaction. Patient feedback (CSQ8) in PACU upon spinal resolution provider feedback (form sent to providers at end of surgery day)

Time frame: PACU upon spinal resolution

Population: This questionnaire was only administered to patients who used the audio-visual aids

The questionnaire consists of 38 questions assessing perioperative satisfaction about five identified themes: trust and atmosphere; fear; discomfort; treatment by personnel; and information and waiting. The questions are rated on a 4-point Likert scale ranging from 0 (unimportant to me) to 3 (very important to me). Higher scores indicate higher levels of satisfaction. Patient satisfaction (Heidelberg Peri-Anaesthetic Questionnaire) in PACU upon spinal resolution.

Time frame: At PACU upon spinal resolution.

Narcotic consumption intraop, postop and POD1

Time frame: Preop until 24 hours after surgery (holding area until POD 1)

Population: POD1 - 13 patients from the AVA group were analyzed due to early discharge.

The percentage of patients who experienced complications (headache, transient neurologic symptoms, nausea and vomiting, ...)

Time frame: Intraoperatively and in the recovery room, average of 3 hours

Number of patients who requested additional sedative medication in the operating room.

Time frame: In the operating room

Anesthesia providers were asked to provide feedback on their experience with the audio-visual aids when the randomization was for the use of the device. This was collected upon surgery end.

Time frame: Sent to providers at end of surgery.

Population: Providers were only asked to provide feedback on the equipment when used by patients in the audiovisual aid group upon surgery end.

Pain scores at rest will be collected from patients using the numerical rating scale (NRS), which asks patients to report their level of pain on a scale from 0 to 10, where 0 represents no pain and 10 represents the worst possible pain. NRS levels in holding area, PACU until discharge from the PACU and one day after surgery, postop day 1.

Time frame: Holding area, Postop (PACU, 30 minutes after arrival to PACU and POD1)

Population: Holding area, PACU arrival, 30 minutes after arrival to PACU and POD1.

Request of Sedation/Termination of AVA (After consent has been obtained until spinal resolution in the recovery room, average of 6 hours)

Time frame: From consent until spinal resolution (avg 6 hs)

Population: This outcome is only providing findings for subjects that has sedation and audiovisual aids with skin conductance monitor. It does not pertain to subjects that had sedation without the AVA.

The maxmimum change in postoperative respiratory rate from holding area until PACU discharge.

Time frame: Measured from preop to postop

Population: Some data was not available for all participants due to equipment not working or due to early discharge

Questionnaire to measure state anixety levels based on a 4-point likert scale and consists of 40 questions. The questionnaire measures two types of anxiety: state anxiety and trait anxiety. State anxiety relates to anxiety about an event, while trait anxiety in anxiety level as a personal characteristic. Scores can range from 20 to 80 and higher scores correlate with more anxiety.

Time frame: holding area and PACU

Population: 4-point likert scale and consists of 40 questions

The maximum change in postoperative systolic and diastolic blood pressure from holding area until PACU discharge.

Time frame: Measured from preop to postop

Population: Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP) for baseline, intra op and post op was recorded.