Anesthesia Satisfaction and Associated Factors among Patients Admitted to the Cardiovascular Intensive Care Unit: A Cross-Sectional Analytical Study
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Abstract
Background: In perioperative care, patient satisfaction is a key quality indicator; however, very little information exists on anesthetic-specific satisfaction among cardiac surgery ICU patients. Patients admitted to the cardiac surgery intensive care unit (ICU) were evaluated in this study for their level of satisfaction.
Methods: Between 2019 and 2020, this cross-sectional analytical research included 186 consecutive adult patients undergoing open-heart surgery at Golestan Hospital, Ahvaz, Iran. The verified Evaluation du Vécu de l'Anesthésie Générale (EVAN-G) scale (score range: 0-100) measured anesthesia satisfaction 48 hours post-extubation. Multivariable linear regression identified predictors of satisfaction.
Results: The mean satisfaction score was 73.8 ± 14.2. High satisfaction (≥80) was reported by 52.7% (n=98). Significant predictors included: Preoperative anxiety therapy (β=8.6, p=0.003), Effective pain control (VAS<4) (β=12.1, p<0.001), Clinician communication quality (β=9.3, p<0.001) and, Absence of PONV (β=7.2, p=0.011). The regression model accounted for 63% of satisfaction variation (R²=0.63, p<0.001).
Conclusion: Modified variables linked with anesthesia satisfaction in patients in a cardiac ICU are active communication, pain management, and preoperative counseling.
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[10] Benítez-Linero I, Fernández-Castellano G, Senent-Boza A, Sánchez-Carrillo F, Docobo-Durantez F. Cross-cultural adaptation, analysis of psychometric properties and validation of the Spanish version of a perioperative satisfaction questionnaire (EVAN-G). Braz J Anesthesiol. 2021;71(1):17-22.
[11] Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798-804.
[12] Makoul G, Krupat E, Chang C-H. Measuring patient views of physician communication skills: development and testing of the Communication Assessment Tool. Patient Educ Couns. 2007;67(3):333-42.
[13] Hernandez Pj, Fuentes Gd, Falcon Al, Rodriguez Ra, Garcia Pc, Roca Cmj. Visual analogue scale for anxiety and Amsterdam preoperative anxiety scale provide a simple and reliable measurement of preoperative anxiety in patients undergoing cardiac surgery. 2015.
[14] Nashef SA, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, et al. Euroscore ii. Eur J Cardiothorac Surg. 2012;41(4):734-45.
[15] Chung AS, Copay AG, Olmscheid N, Campbell D, Walker JB, Chutkan N. Minimum clinically important difference: current trends in the spine literature. Spine. 2017;42(14):1096-105.
[16] Nijs J, Wyns A, Hendrix J. The importance of stress in the paradigm shift from a tissue-and disease-based pain management approach towards multimodal lifestyle interventions for chronic pain. Braz J Phys Ther. 2024;28(2):101061.
[17] Thayer JF, Åhs F, Fredrikson M, Sollers III JJ, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neurosci Biobehav Rev. 2012;36(2):747-56.
[18] Critchley HD, Rotshtein P, Nagai Y, O'Doherty J, Mathias CJ, Dolan RJ. Activity in the human brain predicting differential heart rate responses to emotional facial expressions. Neuroimage. 2005;24(3):751-62.
[19] Nagre A, Singh G. Enhanced Recovery after Cardiac Surgery: A Narrative Review. J Pract Cardiovasc Sci. 2025;11(1):1-7.
[20] Ronaldson A, Kidd T, Poole L, Leigh E, Jahangiri M, Steptoe A. Diurnal cortisol rhythm is associated with adverse cardiac events and mortality in coronary artery bypass patients. J Clin Endocrinol Metab. 2015;100(10):3676-82.
[21] Brown IV CH, Probert J, Healy R, Parish M, Nomura Y, Yamaguchi A, et al. Cognitive decline after delirium in patients undergoing cardiac surgery. Anesthesiology. 2018;129(3):406.
[22] Andrási TB, Talipov I, Dinges G, Arndt C, Rastan AJ. Risk factors for postoperative delirium after cardiac surgical procedures with cardioplegic arrest. Eur J Cardiothorac Surg. 2022;62(1):ezab570.
[23] Timerga S, Befkadu A. Prevalence and associated factors of postoperative nausea and vomiting among adult patients undergoing elective surgery. Ann Med Surg. 2024;86(3):1304-8.
[2] D'Andria Ursoleo J, Licheri M, Barucco G, Losiggio R, Frau G, Pieri M, et al. Remimazolam for anesthesia and sedation in cardiac surgery and for cardiac patients undergoing non-cardiac surgery: a systematic-narrative hybrid review. Minerva Anestesiol. 2024.
[3] Charles EJ, Mehaffey JH, Hawkins RB, Burks SG, McMurry TL, Yarboro LT, et al. Meaningful patient-centered outcomes 1 year following cardiac surgery. Ann Surg. 2021;273(6):e247-e54.
[4] Claessens J, Yilmaz A, Mostien T, Van Genechten S, Claes M, Packlé L, et al. 90-day patient-centered outcomes after totally endoscopic cardiac surgery: a prospective cohort study. J Clin Med. 2022;11(9):2674.
[5] Joselyn AS, Suhag K, Paul PA. A Cross-sectional Study to Assess the Level of Patient Satisfaction with Day-care Anesthesia Services in a Tertiary Care Teaching Hospital in South India. Curr Meی Issues. 2025;23(2):97-101.
[6] Xu M, Zhang G, Tang Y, Wang R, Yang J. Impact of regional anesthesia on subjective quality of recovery in patients undergoing thoracic surgery: a systematic review and meta-analysis. J Cardiothorac Vasc Anesth. 2023;37(9):1744-50.
[7] Patient OA. Postoperative Visual Analog Pain Scores and Pain Management, An Issue of Critical Nursing Clinics. 2017;29(4):419.
[8] Mondal S, Bergbower EA, Cheung E, Grewal AS, Ghoreishi M, Hollander KN, et al. Role of cardiac anesthesiologists in intraoperative Enhanced Recovery After Cardiac Surgery (ERACS) Protocol: a retrospective single-center study analyzing preliminary results of a yearlong ERACS protocol implementation. J Cardiothorac Vasc Anesth. 2023;37(12):2450-60.
[9] Nambiar PM, Bhan A, Mehta Y. Prolonged Stay in ICU after Cardiac Surgery: Challenges–A Review. J Card Crit Care TSS. 2024;8(2):70-9.
[10] Benítez-Linero I, Fernández-Castellano G, Senent-Boza A, Sánchez-Carrillo F, Docobo-Durantez F. Cross-cultural adaptation, analysis of psychometric properties and validation of the Spanish version of a perioperative satisfaction questionnaire (EVAN-G). Braz J Anesthesiol. 2021;71(1):17-22.
[11] Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. J Clin Nurs. 2005;14(7):798-804.
[12] Makoul G, Krupat E, Chang C-H. Measuring patient views of physician communication skills: development and testing of the Communication Assessment Tool. Patient Educ Couns. 2007;67(3):333-42.
[13] Hernandez Pj, Fuentes Gd, Falcon Al, Rodriguez Ra, Garcia Pc, Roca Cmj. Visual analogue scale for anxiety and Amsterdam preoperative anxiety scale provide a simple and reliable measurement of preoperative anxiety in patients undergoing cardiac surgery. 2015.
[14] Nashef SA, Roques F, Sharples LD, Nilsson J, Smith C, Goldstone AR, et al. Euroscore ii. Eur J Cardiothorac Surg. 2012;41(4):734-45.
[15] Chung AS, Copay AG, Olmscheid N, Campbell D, Walker JB, Chutkan N. Minimum clinically important difference: current trends in the spine literature. Spine. 2017;42(14):1096-105.
[16] Nijs J, Wyns A, Hendrix J. The importance of stress in the paradigm shift from a tissue-and disease-based pain management approach towards multimodal lifestyle interventions for chronic pain. Braz J Phys Ther. 2024;28(2):101061.
[17] Thayer JF, Åhs F, Fredrikson M, Sollers III JJ, Wager TD. A meta-analysis of heart rate variability and neuroimaging studies: implications for heart rate variability as a marker of stress and health. Neurosci Biobehav Rev. 2012;36(2):747-56.
[18] Critchley HD, Rotshtein P, Nagai Y, O'Doherty J, Mathias CJ, Dolan RJ. Activity in the human brain predicting differential heart rate responses to emotional facial expressions. Neuroimage. 2005;24(3):751-62.
[19] Nagre A, Singh G. Enhanced Recovery after Cardiac Surgery: A Narrative Review. J Pract Cardiovasc Sci. 2025;11(1):1-7.
[20] Ronaldson A, Kidd T, Poole L, Leigh E, Jahangiri M, Steptoe A. Diurnal cortisol rhythm is associated with adverse cardiac events and mortality in coronary artery bypass patients. J Clin Endocrinol Metab. 2015;100(10):3676-82.
[21] Brown IV CH, Probert J, Healy R, Parish M, Nomura Y, Yamaguchi A, et al. Cognitive decline after delirium in patients undergoing cardiac surgery. Anesthesiology. 2018;129(3):406.
[22] Andrási TB, Talipov I, Dinges G, Arndt C, Rastan AJ. Risk factors for postoperative delirium after cardiac surgical procedures with cardioplegic arrest. Eur J Cardiothorac Surg. 2022;62(1):ezab570.
[23] Timerga S, Befkadu A. Prevalence and associated factors of postoperative nausea and vomiting among adult patients undergoing elective surgery. Ann Med Surg. 2024;86(3):1304-8.
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How to Cite
1.
Javaherforooshzadeh F, Parhiz S, Gholizadeh B. Anesthesia Satisfaction and Associated Factors among Patients Admitted to the Cardiovascular Intensive Care Unit: A Cross-Sectional Analytical Study. Arch Anesth & Crit Care. 2025;.
