Susan Larson β™€οΈπŸ³οΈβ€πŸŒˆπŸ³οΈβ€βš§οΈπŸŒˆJul 2, 2024

#LivedExperiences of #transgender and #nonbinary #people in the #perioperative #context: a #qualitative #study.

Additional #research, increased #education for #healthcare #professionals, and #policy #changes are necessary to improve #access to #competent #care for #TNB #Epeople.

#Women #Transgender #LGBTQ #LGBTQIA #Transitioning #Healthcare #Representation #Culture

https://www.cmaj.ca/content/196/24/E806

Lived experiences of transgender and nonbinary people in the perioperative context: a qualitative study

Background: Transgender and nonbinary (TNB) people experience obstacles that create barriers to accessing health care, including stigmatization and health inequities. Our intention was to describe the lived experiences of TNB patients and identify potential gaps in the education of health care professionals. Methods: We conducted a qualitative descriptive study influenced by phenomenology by interviewing with TNB adults who underwent surgery in Canada within the previous 5 years. We recruited participants using purposeful and snowball sampling via online social networking sites. Audio recordings were transcribed. Two authors coded the transcripts and derived the themes. Results: We interviewed 21 participants, with a median interview duration of 49 minutes. Participants described positive and negative health care encounters that led to stress, confusion, and feelings of vulnerability. Major themes included having to justify their need for health care in the face of structural discrimination; fear and previous traumatic experiences; community as a source of support and information; and the impact of interactions with health care professionals. Interpretation: Participants detailed barriers to accessing care, struggled to participate in shared decision-making, and desired trauma-informed care principles; they described strength in community and positive interactions with health care professionals, although barriers to accessing gender-affirming care often overshadowed other aspects of the perioperative experience. Additional research, increased education for health care professionals, and policy changes are necessary to improve access to competent care for TNB people. [See related editorial at www.cmaj.ca/lookup/doi/10.1503/cmaj.240878][1] [1]: /lookup/volpage/196/E828

CMAJ
β„΅β‚€ πŸ³οΈβ€βš§οΈπŸ΄β€β˜ οΈApr 5, 2023
It's been 5 weeks and I'm still feeling considerable adverse effects from the general #anesthesia hangover. I'm told it's post-operative cognitive dysfunction, and that it should pass in time but it seems to be worsening. I'm frankly terrified, and don't know what to do. Still waiting on the requested #anesthesiologist, #preoperative, #perioperative #medication reports. Experienced a degree of delayed recall of #surgical events; nightmarish sense of entrapment, #asphyxiation, pressure, & dread.
Bruce SmithFeb 17, 2023

The linked study of 225 patients concludes: "Binaural tone music and patient choice music can be suitable alternatives to pharmacological therapies for perioperative anxiolysis."

Tunes, not drugs.

#music #medicine #anxiolysis #perioperative #health #surgery

https://www.cureus.com/articles/119224-comparison-of-binaural-tone-music-vs-patient-choice-music-vs-midazolam-on-perioperative-anxiety-in-patients-posted-for-surgery-under-spinal-anaesthesia-a-randomized-control-trial?score_article=true#!/

Comparison of Binaural Tone Music vs Patient Choice Music vs Midazolam on Perioperative Anxiety in Patients Posted for Surgery Under Spinal Anaesthesia: a Randomized Control Trial

Background Perioperative anxiety affects patients' hemodynamics by increasing stress levels, leading to delayed recovery. In this study, we compared the anxiety-reducing effect of music (patient choice and binaural tone music) with midazolam for perioperative anxiolysis in patients undergoing surgery under spinal anaesthesia. Methods After obtaining institutional ethical clearance and informed written consent, a total of 225 patients classified as ASA grades 1 and 2 (American Society of Anesthesiologists) were enrolled and randomised into three groups of 75 patients per group. Group A patients received research-selected music (binaural tone) via noise-cancelling headphones, Group B received intravenous midazolam (minimum of 1 mg to 2 mg maximum) as per clinical judgement, and Group C participants provided patient-preferred music via noise-cancelling headphones. The patient's perioperative anxiety was assessed using a visual analogue anxiety scale at regular time intervals. Results Anxiety scores were significantly reduced in the patient's choice music group (Group C) and binaural tone music group (Group A) as compared to the midazolam group (Group B). Postoperative pain scores were statistically significantly lower in Group C, followed by Group A and Group B. On comparing patient satisfaction scores, using numerical rating scores, 96% of patients in Group C achieved excellent scores with a p-value of 0.007. Conclusion Binaural tone music and patient choice music can be suitable alternatives to pharmacological therapies for perioperative anxiolysis.

Iain McCullaghNov 15, 2022
#introduction, I’m a crit care and anaesthesia consultant in Newcastle. Keeping trying to be a #researcher in #perioperative and #ICU #delirium! Keen on #research #management and delivery. #Singer in a covers band in some of my spare time! Interested to see how this evolves!