Anesthesia Patient Safety Podcast

#254 The Patient's Guide to Anesthesia and Surgery

• Anesthesia Patient Safety Foundation • Episode 254

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Fear of the unknown can make surgery and anesthesia unnecessarily stressful. Approximately 90% of patients experience some degree of anxiety about "going under" before their procedure – worrying about pain, waking during surgery, or post-operative grogginess. But what if patients had reliable answers to their most pressing questions?

The Anesthesia Patient Safety Foundation has developed a groundbreaking resource to address this need. In this episode, we introduce the Patient Guide to Anesthesia and Surgery – a comprehensive tool designed to demystify the perioperative experience. Salvador Gullo Neto, lead of the APSF Patient Engagement Workgroup, explains why patient involvement matters: "If the patient is the primary stakeholder in their own safety, why are they left out of these conversations?" 

We explore the guide's three detailed sections – Anesthesia FAQ, Surgery FAQ, and Pain Management FAQ – covering everything from different types of anesthesia to essential questions patients should ask their clinicians before surgery. The guide addresses common concerns like the risks of anesthesia, what to expect during recovery, and options for managing post-operative pain. For medical professionals, it serves as a valuable reference during patient consultations.

Healthcare has evolved from being done "for" patients to being done "with" patients as active participants. This shift represents the future of medical care – a collaborative approach where informed patients and dedicated healthcare professionals work together to achieve the best possible outcomes. We hope that you will check out this invaluable resource today and share it with patients, colleagues, and loved ones. Visit APSF.org or check our show notes for more information.

For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/254-the-patients-guide-to-anesthesia-and-surgery/

© 2025, The Anesthesia Patient Safety Foundation

Marjorie Striegler:

You're listening to the Anesthesia Patient Safety Podcast, the official podcast of the Anesthesia Patient Safety Foundation. We're bringing you the very best from the APSF newsletter and website, as well as the latest information in perioperative patient safety. Thanks for joining us.

Alli Bechtel:

Hello and welcome back to the Anesthesia Patient Safety Podcast. My name is Allie Bechtel and I'm your host. Thank you for joining us for another show. We are introducing a new APSF patient safety resource today. That's right. We are talking about the Patient Guide to Anesthesia and Surgery. This guide was developed by the Anesthesia Patient Safety Foundation's Patient Engagement Workgroup to help answer some of the most common questions that patients have before surgery and anesthesia care. This is an important resource to help patients become more involved in their health care and learn more about what they can do to mitigate surgical risks and complications.

Alli Bechtel:

We are going to go through the guide today, so this is a good podcast to share with patients too. Before we dive further into the episode today, we'd like to recognize Nihon Kodan, a major corporate supporter of APSF. Nihon Kodan has generously provided unrestricted support to further our vision that no one shall be harmed by anesthesia care. Thank you, nihon Kodan. We wouldn't be able to do all that we do without you. Before we get into the patient guide, we are going to hear from Salvador Gullo Neto, who is the lead for the Patient Engagement Workgroup and this guide. Here he is now.

Salvador Gullo Neto:

Hello, my name is Salvador Gullo Neto. I'm a general surgeon at Hospital São Lucas da PUC in Brazil and the APSF Patient Engagement Workgroup lead the APSF Patient Engagement Workgroup lead.

Alli Bechtel:

We wanted to hear a little more from Gullo Neto, so I asked him how he became involved in the APSF and why he is so passionate about patient safety. Let's take a listen now.

Salvador Gullo Neto:

I was part of a working group at the Patient Safety Movement Foundation, and some colleagues who worked with me in this group mentioned that APSF was starting a new initiative focused on patient engagement for their own safety and invited me to participate. I found the initiative spectacular and immediately accepted the invitation. When we graduate as doctors, we take the Hippocratic Oath affirming that, above all, we must first do no harm. Unfortunately, we know that this is not always the reality and even unintentionally, we'd end up causing harm to patients. I believe this is directly related to the training we receive. During my medical education in the 90s, I received very little training on how to prevent adverse events and failures in healthcare. I understand that even today, many medical schools address patient safety in a superficial and insufficient manner. When I recognized this significant gap in the healthcare system, I realized that I should dedicate myself to this issue and work towards transforming this reality.

Alli Bechtel:

I also asked Gullo Neto what got him interested in this patient focus initiative. Let's take a listen to what he had to say.

Salvador Gullo Neto:

In 2013, the Brazilian Ministry of Health launched the National Patient Safety Program. As part of this initiative, all teaching hospitals in Brazil were required to have a patient safety office, and I was invited to organize this project at Hospital São Lucas da PUC, where I am an assistant professor of surgery. Since then, I have been dedicated to this subject and quickly understood that true healthcare transformation will only happen when patients and their families are genuinely engaged. Patient safety is a shared responsibility between healthcare professionals, patients, their families and caregivers.

Alli Bechtel:

Thank you so much to Gullo Neto for helping to kick off the show today, introducing this important topic and your dedication to patient safety. And now it's time to discuss the patient guide to anesthesia and surgery. To follow along with us, head over to APpsforg and click on the patient safety resources heading. The fourth one up from the bottom is the patient guide to anesthesia and surgery. I will include the link in the show notes as well. There are three sections in the guide, including anesthesia FAQ, surgery FAQ and pain management FAQ. We are going to start with the anesthesia frequently asked questions.

Alli Bechtel:

Patients often have questions and concerns about anesthesia. It may be challenging to address all of these concerns in a busy, loud and stressful preoperative area immediately before surgery. When patients present to a preoperative area immediately before surgery, when patients present to a preoperative anesthesia clinic, there may be more time to address these concerns and you can use this patient guide to help. The anesthesia section includes information about different types of anesthesia, side effects and what to expect after waking up from surgery. Did you know that almost 90% of patients feel some fear about anesthesia before surgery? Some of the most common concerns include post-operative pain, waking up during surgery and sleepiness after surgery. The good news is that we can reassure patients that anesthesia is generally safe and effective when administered by a trained professional. But, like any medical procedure, it has risks. When was the last time a patient asked you how safe is anesthesia? How did you respond? The patient guide reviews common fears and concerns in the following categories Waking up from anesthesia, including how long does it take to wake up from anesthesia. What if I have trouble waking up from anesthesia and what happens if I wake up during surgery. Side effects, including what are the side effects of anesthesia and are there long-term side effects of anesthesia. Complications, including what is the risk of dying from anesthesia. Can anesthesia cause brain damage. How many times is it safe to go under anesthesia and can I be allergic to anesthesia. Miscellaneous concerns may include are there alternatives to general anesthesia? Do redheads need more anesthesia and why does local anesthesia not work on me?

Alli Bechtel:

Patients may want to know more information about the different types of anesthesia. The patient guide provides an infographic depicting the four types of anesthesia, including local, regional sedation and general anesthesia, as well as information about each of these. The next section includes information about the different drugs used during anesthesia care, with information about pain relievers, anti-anxiety medications, local anesthetics, general anesthetics and muscle relaxers or paralytics? In the patient guide, you can click on each of these questions and be directed to additional information. The guide is meant to be read and understood by patients and family members and includes so much information to help address these questions and concerns. Anesthesia professionals can also use this guide to help in conversations with patients and their family.

Alli Bechtel:

Let's move on to the surgery frequently asked questions section. This section is designed to help patients understand risk factors and what they can do to prepare for surgery, to minimize complications and ensure the best possible recovery. Here are the questions included in this guide Is surgery necessary? How do I pay for surgery? How do I prepare for surgery? Questions to ask your anesthesia professional. Questions to ask your surgeon what are risk factors for surgery? Will I feel pain after surgery and how do I speed up healing after surgery? I want to highlight a couple of these sections. Go ahead and click on the questions to ask your anesthesia professional. There is a list of questions here that patients may bring to their preoperative anesthesia clinic visit or have ready to go on the morning of surgery.

Alli Bechtel:

It is important that anesthesia professionals are prepared to answer these questions, which include the following what type of anesthesia do you recommend for my procedure and why? What may I expect as after effects of anesthesia? May I share what matters and concerns me most about anesthesia? What are special anesthesia considerations for my specific medical conditions? Should I expect pain during recovery from this procedure? How will we handle it and what options are available? Do your recommendations change because of my specific medical history with pain management? Maybe a specific medicine doesn't work for me?

Alli Bechtel:

I am sensitive to all medications. Will anesthesia affect my cognitive functioning, brain function and memory, and what might I expect and what can I do to help? What should I not do before anesthesia and surgery? What medications should I take and what medications should I not take before surgery? What else can I do to help myself be strong and fit for anesthesia and surgery? What else can I do to help myself be strong and fit for anesthesia and surgery? Who will be my anesthesia team and what is the experience and qualifications of the team? The next section is questions to ask your surgeon. This is a good list to help patients talk to their surgeon before surgery about their concerns. This may be a very stressful time and having these questions prepared can go a long way towards improving patient engagement and shared responsibility and decision-making here are the questions.

Alli Bechtel:

What is the exact procedure that you will be performing? Can you draw a diagram to help me understand, or do you have a pamphlet explaining the procedure? How is the surgery going to make things better for me? What are alternatives? What if I don't choose to have surgery?

Alli Bechtel:

What impact will surgery and recovery have on my daily life? What will recovery look like and how long will it take before I feel improvement from the surgery? When will I be able to go back to work or school or babysitting my grandchildren or something else that's important to you? What does a best case scenario look like for me? What does a worst case scenario look like for me, given my health and medical conditions? What is the most likely outcome? What can I do to prepare myself physically and mentally? What can I do to prepare my home for after surgery?

Alli Bechtel:

And finally, may I share what the final section is, pain management, which is designed to help patients learn more about pain management options following surgery, as well as for acute and chronic conditions. This FAQ includes the following questions what are the types of pain? What should I know about pain management? How can I manage pain without medications? What non-opioid medications are used in pain management? How can I manage pain without medications? What non-opioid medications are used in pain management? What opioids are used in pain management? What are the risks of using opioid medications? There is an amazing amount of information in this patient guide. Next week, our show will be designed for patients and healthcare professionals. As we go through some of the questions and answers, we are putting the guide to work and we hope that you will tune in. Before we wrap up for today, we are going to hear from Gullo Neto again. I also asked him what he envisions for the future when it comes to patients as active participants in their healthcare and what he hopes to see going forward. Here is his response.

Salvador Gullo Neto:

This is a path with no return. Healthcare has transitioned from for the patient to by the patient and now finally arriving at with the patient. If the patient is the primary stakeholder in their own safety, why are they left out of these conversations? We need to include patients in all forums related to the healthcare sector. I hope for a shift in mindset for all stakeholders and mindset for all stakeholders On our side as healthcare professionals. I hope we become more receptive to the idea that patients and their families are a fundamental part of healthcare outcomes and that their involvement facilitates our work and leads to better results. On the part of patients and caregivers, I hope to see more active participation, contributing to the decision-making process and their own treatment.

Alli Bechtel:

I also wanted to know what was next for his research and projects. And it's exciting. Let's take a listen.

Salvador Gullo Neto:

I have been working on straightening a patient safety perception score where patients and their caregivers can access how well they perceive the implementation of the World Health Organization's six patient safety goals. We call this score the NPSS or Net Promoter Score for Patient Safety. In addition to asking patients how they perceive the execution of basic safety protocols, this score encourages interactions between healthcare teams and patients regarding best practice, increasing knowledge among the general public and, ultimately, straightening the patient safety culture within institutions strengthening the patient safety culture within institutions.

Alli Bechtel:

Thank you so much to Gullo Neto for contributing to the show today and discussing this awesome patient safety resource. We hope that you will check out the Patient Guide to Anesthesia and Surgery and share this resource with your colleagues, perioperative team members, patients, friends and family members. Check out the link in the show notes. If you have any questions or comments from today's show, please email us at podcast at apsforg. Please keep in mind that the information in this show is provided for informational purposes only and does not constitute medical or legal advice. We hope that you will visit aSForg for detailed information and check out the show notes for links to all the topics we discussed today.

Alli Bechtel:

Submissions are now open for the 2025 APSF Trainee Quality Improvement Patient Safety Recognition Program. This is open for all US and Canadian anesthesia professionals in training, including physician anesthesiology residents, nurse, anesthesia students and student anesthesiologist assistants. Winners will be notified in August and be sponsored to attend the 2025 Stolting Conference in Chicago, illinois to share their work and network with attendees. Submissions will be accepted as a document or audio or video recording. The submission deadline is June 1st 2025 at 1159 pm Eastern Standard Time. I will include the link in the show notes for more information. This is an exciting opportunity that you do not want to miss. Until next time, stay vigilant so that no one shall be harmed by anesthesia care.