Clinical Characteristics and Anesthetic Satisfaction of Patients from Southeast Mexico Undergoing Total Knee Arthroplasty: A Cross Sectional Study

Abstract

Background: The Total knee arthroplasty aims to significantly improve functionality and quality life. However, clinical characteristics of patients and their satisfaction with the anesthetic process have been understudied in public institutions in Southeast Mexico, despite the prevalence of risk factors such as age ≥ 50 and obesity. The results will indicate hemodynamic behavior during and after surgery, anesthetic management and degree satisfaction whit intervention establishing clinical and methodological foundations that will allow future studies to be carried out that incorporate a greater number of patients and variables. Aim: To know clinical characteristics and anesthetic satisfaction of patients from Southeast Mexico undergoing total knee arthroplasty. Methods:  One time cross sectional survey [descriptive study; ethical approval folio: R-2024-703-062] in patients both sexes, aged ≥ 55 years, undergoing total knee arthroplasty in a Second Level Public Hospital in Southeast Mexico during November 2023 - August 2024. Patients who were transferred to other medical units were excluded. Demographic data [sex, age, Body Mass Index (BMI)]; clinical data [American Society of Anesthesiologists Physical Status Classification System (ASA), hemodynamic variables, Visual Analogue Scale (VAS)]; and Iowa Satisfaction with Anesthesia Scale (ISAS) [15 minutes after admission to the post-anesthesia care unit] were collected. Descriptive statistics were performed using Statistical Package for the Social Sciences (SPSS) version 25. Results: The study included 31 patients. Women predominated (67.7%). The age and BMI were 67.4 ± 7.1 years and 30.9 ± 2.8 kg/m² respectively. ASA classification was II for all patients. Hemodynamic variables showed higher values ​​at the start intervention; these decreased in the post-anesthesia care unit. The VAS scores at 2, 4 and 8 hours post-procedure were 4.0 ± 1.2, 5.8 ± 1.9 and 5.5 ± 1.3, respectively. Overall ISAS score was 1.9 ± 2.4; and scores recorded for items were:  “I vomited or felt nauseous” 0.3 ± 2.4; “I felt itchy” -2.2 ± 1.6; “I felt pain” -2.5 ± 1.4; “I felt very cold or hot” -1.2 ± 2.3; “I felt pain during the surgery” -2.8 ± 1.1; “I felt hurt” -2.7 ± 0.8; “I would like to receive the same anesthesia again” 2.7 ± 1.0; “I felt relaxed, calm” 2.6 ± 0.6; “I felt safe, confident” 2.7 ± 0.5; “I was satisfied, happy with my anesthetic care” 2.6 ± 1.0; and “I felt good” 2.5 ± 0.6. Conclusion: Patients undergoing total knee arthroplasty in Southeast Mexico were primarily women. The ages 55–74 and obesity were predominant. Hemodynamic instability was recorded mainly during the procedure. Moderate pain intensity was the most common finding. Anesthetic satisfaction was moderately.  Further research into anesthetic strategies is needed to improve the quality of care. Understanding clinical characteristics is essential for providing optimal anesthetic conditions, thereby reducing the likelihood of adverse events and high hospital costs.