RESUMEN
BACKGROUND: Patient satisfaction is a reliable and measurable indicator of the quality provided by a healthcare service. There are several questionnaires for measuring it, but only a few have shown good psychometric properties, an outstanding one being the EVAN-G (Evaluation du Vécu de l'Anesthésie Générale) questionnaire, which measures patient satisfaction regarding perioperative care and is validated in French. The aim of this study is the validation of a Spanish version of the EVAN-G questionnaire. METHODS: A translation/back-translation of the questionnaire into Spanish was carried out and the final version obtained was administered to three hundred patients. Its psychometric properties were measured and compared with those of the original EVAN-G questionnaire to verify that they had been maintained after the previous translation process. The questionnaire's content, construct and external validity were measured. To calculate reliability, Cronbach-α coefficient and test-retest method were used. The Global Satisfaction Index was calculated and satisfaction level in our sample was analyzed. RESULTS: Content, construct and external validity were proven with similar results that in the original EVAN-G. The translated version of the questionnaire showed good reliability: Cronbach-α coefficient was 0.92 and intraclass correlation coefficient measured by test-retest method was 0.9. The acceptability was high. The average Global Satisfaction Index in our sample was 73±12. CONCLUSIONS: The translation into Spanish and cross-cultural adaptation of the EVAN-G questionnaire has proven its validity, reliability, and acceptability to measure patient satisfaction in interventions performed under general anesthesia.
Asunto(s)
Comparación Transcultural , Satisfacción Personal , Humanos , Psicometría , Reproducibilidad de los Resultados , Encuestas y Cuestionarios , TraduccionesRESUMEN
Introduction: Parry-Romberg Syndrome is a rare degenerative disease characterized by unilateral atrophy affecting the skin, connective tissue, muscle and bone. The end result is facial asymmetry associated with other skin, dental, visual, cardiovascular, and neurological disorders. Clinical findings, diagnostic evaluation and interventions: The case of a patient with Parry-Romberg Syndrome programmed for frontonasal flap remodeling is discussed. The patient's history includes trigeminal neuralgia, epilepsy, and two previous surgical interventions. Uneventful endotracheal intubation with the Glideoscope® video laryngoscope was performed, upon adequate pre-oxygenation followed by anesthetic induction. Conclusion: The phenotypical characteristics of Parry Romberg Syndrome are severe facial hemiatrophy and craniofacial anomalies that require careful preoperative evaluation and management of a potentially difficult airway. Consequently, the use of video laryngoscopes is a first-line approach. Due to the syndrome's associated disorders, it is essential to maintain hemodynamic stability and prevent any potential seizures.
Introducción: El Síndrome de Parry-Romberg es una enfermedad degenerativa poco común, caracterizada por una atrofia unilateral que afecta la piel, el tejido conjuntivo, el músculo y el hueso. El resultado final es una asimetría facial cursando con otras alteraciones cutáneas, dentales, oculares, cardiovasculares y neurológicas. Hallazgos clínicos, evaluación diagnóstica e intervenciones: Presentamos un caso de un paciente con Síndrome de Parry-Romberg programado para remodelación de colgajo frontonasal. Entre sus antecedentes destacan neuralgia del trigémino, epilepsia y dos intervenciones quirúrgicas previas. Tras una adecuada preoxigenación y posterior inducción anestésica, se realiza una intubación endotraqueal sin incidencias mediante el videolaringoscopio Glideoscope®. Conclusión: El Síndrome de Parry Romberg presenta como características fenotípicas hemiatrofia facial grave y anomalías craneofaciales, que requieren una cuidadosa evaluación preoperatoria y el manejo de una vía aérea potencialmente difícil. Es por esto que los videolaringoscopios resultan una alternativa de primera línea. Debido a sus trastornos asociados, es esencial mantener la estabilidad hemodinámica y la prevención de posibles crisis convulsivas.
Asunto(s)
HumanosRESUMEN
Introduction: Valved conduits for surgically reconstructing the outflow tract of the right ventricle have improved the prognosis for certain congenital heart diseases. When they become dysfunctional, transcatheter pulmonary valve replacement is safe and effective. Clinical findings, diagnostic evaluation and interventions: We report the case of a 21 years old female patient diagnosed with transposition of great vessels corrected in childhood. After several surgeries, she presents a dysfunction of the right ventricle. In response, a "Melody " pulmonary valve was implanted percutaneously under deep sedation. Conclusion: The ideal anesthetic technique for transcatheter pulmonary valve replacement is controversial. There is a debate over the merits of general anesthesia and deep sedation. Each case must be decided on after a careful preoperative evaluation, considering the risk/benefit and patient cooperation. The experience at our center using deep sedation is promising, but we have an alternative plan to convert to general anesthesia if necessary.
Introducción: Los conductos valvulados para reconstruir quirúrgicamente el tracto de salida del ventrículo derecho han mejorado el pronóstico de ciertas cardiopatía congénitas. Cuando éstos se vuelven disfuncionantes, el remplazo valvular pulmonar transcatéter es eficaz y seguro. Hallazgos clínicos, evaluación diagnóstica e intervenciones: Presentamos una paciente de 21 años, diagnosticada de transposición de grandes vasos corregida en la infancia, que tras varias intervenciones quirúrgicas presenta una disfunción del conducto del ventrículo derecho, por lo que se implanta percutáneamente una válvula pulmonar "Melody" bajo sedación profunda. Conclusión: La técnica anestésica ideal para el recambio valvular transcatéter pulmonar es controvertida, discutiéndose entre la anestesia general y la sedación profunda. Cada caso debe decidirse tras una evaluación preoperatoria cuidadosa, considerando el riesgo/beneficio y la colaboración del paciente. La experiencia en nuestro centro empleando la sedación profunda es prometedora, aunque debemos contar con un plan alternativo para reconvertir a anestesia general de ser necesario.