JMIR Publications

ABSTRACT

Background:

More than 300 million patients undergo surgical procedures requiring anesthesia worldwide annually.[1] There are two standard-of-care general anesthesia administration options: inhaled volatile anesthesia (INVA) and total intravenous anesthesia (TIVA). There is limited evidence comparing these methods and their impact on patient experiences and outcomes. Patients often seek this information from sources such as the internet. However, the majority of websites on anesthesia-related topics are not comprehensive, updated, and/or fully accurate[2–9]. The quality and availability of online patient information about INVA and TIVA have not been sufficiently examined.

Objective:

This study aimed to 1) assess information on the internet about INVA and TIVA for availability, readability, accuracy, and quality, and 2) identify high-quality websites that can be recommended to patients to assist in their anesthesia information seeking and/or decision-making.

Methods:

Online searches were conducted using Google from April 2022 to November 2022. Websites were coded using a coding instrument developed based on the International Patient Decision Aids Standards (IPDAS) criteria[10,11] and adapted to be appropriate for assessing websites describing INVA and TIVA. Readability was calculated with the Flesch-Kincaid (F-K) Grade Level[12] and the Simple Measure of Gobbledygook (SMOG) Readability Formula[13].

Results:

Sixty seven websites containing 201 individual webpages were included for coding and analysis. Most of the websites provided a basic definition of general anesthesia (unconsciousness, n = 57 [85%]; analgesia, n = 47 [70%]). Around half of the websites described common side effects of general anesthesia, while fewer described the rare but serious adverse events, such as intraoperative awareness (n = 31 [46%]), allergic reactions or anaphylaxis (n = 29 [43%]), and malignant hyperthermia (n = 18 [27%]). Of the 67 websites, the median F-K Grade Level was 11.3, and the median SMOG score was 13.5. Fifty-one websites (76%) distinguished INVA versus TIVA as general anesthesia options. Twelve of the 51 websites (24%) explicitly stated that there is a decision to be considered about receiving INVA versus TIVA for general anesthesia. Only 10 websites (20%) made any direct comparisons between INVA and TIVA, discussing their positive and/or negative features. Twelve websites (24%) addressed the concept of shared decision making in planning anesthesia care, but none specifically asked patients to think about which features of INVA and TIVA matter the most to them.

Conclusions:

While the majority of websites described INVA and TIVA, few provided comparisons. There is a need for high-quality patient education and decision support about the choice of INVA versus TIVA to provide accurate and more comprehensive information in a format conducive to patient understanding.