The anesthesia safety decree made it compulsory in 1994 to carry out a pre-anesthesia consultation before any operative or interventional act. With the inclusion of telemedicine in the Public Health Code then the publication of Addendum 6 in 2018 and finally the derogatory decree in March 2020, it is possible to perform and bill for pre-anesthesia consultation via telemedicine. The consultation is always followed by a pre-anesthetic visit upon admission of the patient the day before or the day of the operation to verify the information recorded during the consultation and the patient's state of health. This identifies elements omitted during the pre-anesthesia consultation (face-to-face or remotely) and reduces the risks of potential postponement. The study investigators hypothesize that there would be no difference in the quality of the information given, the collection of medical, paramedical and medication elements and the evaluation of the operative risk in anesthesia consultation via teleconsultation versus face-to-face. The critical points are the medication reconciliation of the patient's treatments, the overall assessment of the operative risk and anticipated difficulty of access to the airways (mouth opening: ≥ or \<35 mmm).
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
SINGLE
Enrollment
172
The anesthesia consultation is carried out in person in accordance with the usual management.
Anesthesia consultation is carried out in teleconsultation via the "Téléo" web application (audio and video) at the patient's home on a computer or smartphone. This application allows sending and receiving documents identical to those during the face-to-face consultation.
Centre Hospitalier Universitaire de Nîmes
Nîmes, Gard, France
Elevated American Society of Anesthesiologists (ASA) score in each group
Yes/no for if score=3-4
Time frame: anesthesia consultation = 1 week to 3 months after inclusion
Elevated American Society of Anesthesiologists (ASA) score in each group
Yes/no for if score=3-4
Time frame: pre-anesthetic visit = 9 days to 3 months+7 days after inclusion
Difficulty in accessing airways each group
Yes/no for mouth opening ≥35 mm
Time frame: anesthesia consultation = 1 week to 3 months after inclusion
Difficulty in accessing airways each group
Yes/no for mouth opening ≥35 mm
Time frame: pre-anesthetic visit = 9 days to 3 months+7 days after inclusion
Medication conciliation performed during the anesthesia consultation each group
Yes/no: adaptations of selected therapies: anticoagulants, anti-aggregants, anti-hypertension, antidiabetics
Time frame: pre-anesthetic visit = 9 days to 3 months+7 days after inclusion
Medication conciliation performed during the anesthesia consultation each group
Yes/no: adaptations of selected therapies: anticoagulants, anti-aggregants, anti-hypertension, antidiabetics
Time frame: anesthesia consultation = 1 week to 3 months after inclusion
Difference between groups in composite score of above outcomes (elevated ASA score, difficulty accessing airways and medication conciliation)
Difference in number of yes/no answers at anesthesia consultation compared to pre- anesthetic visit
Time frame: pre-anesthetic visit = 9 days to 3 months+7 days after inclusion
Difference between groups in composite score of above outcomes (elevated ASA score, difficulty accessing airways and medication conciliation)
Difference in number of yes/no answers at anesthesia consultation compared to pre- anesthetic visit
Time frame: anesthesia consultation = 1 week to 3 months after inclusion
Number of canceled surgeries in each group
Yes/no surgery not performed on the scheduled day and / or postponed \> 2 days
Time frame: Day 2 after pre-anesthetic visit
Reason for cancellation of surgery
Description noted in electronic clinical report form
Time frame: Day 2 after pre-anesthetic visit
Number of delayed surgeries in each group
Yes/no surgery not performed on the scheduled day and / or postponed ≤ 2 days
Time frame: Day 2 after pre-anesthetic visit
Reason for delayed surgery
Description noted in electronic clinical report form
Time frame: Day 2 after pre-anesthetic visit
Complication rate in perioperative and immediate postoperative period
% patients with a complication
Time frame: 2 days post-operatively
Rate of anesthesia consultation rescheduling in each group
Number of consultations rescheduled
Time frame: 2 days after pre-anesthetic visit
Reason for rescheduling
Description noted in electronic clinical report form
Time frame: 2 days after pre-anesthetic visit
Global patient satisfaction
satisfaction on a visual analog scale 0-10
Time frame: pre-anesthetic visit = 9 days to 3 months+7 days after inclusion
Satisfaction on the delivery of the information
6-item custom questionnaire completed on a Likert 0 - 5 scale for all patients plus 6 questions specific for control group and 7 for intervention group
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Time frame: pre-anesthetic visit = 9 days to 3 months+7 days after inclusion
Ecological impact of the consultation in each group
Carbon impact (CO2 generated) of number of km between the patient's home and the hospital
Time frame: pre-anesthetic visit = 9 days to 3 months+7 days after inclusion
Economic impact of the consultation in each group
Cost in euros of cost of travel and time at work missed
Time frame: pre-anesthetic visit = 9 days to 3 months+7 days after inclusion
Rate of presence of the usual treatment prescription
Yes/no
Time frame: During the anesthesia consultation = 1 week to 3 months after inclusion
Rate of presence of the completed health questionnaire
Yes/no
Time frame: During the anesthesia consultation = 1 week to 3 months after inclusion
Rate of presence of specialist consultation reports less than 1 year old
Yes/no
Time frame: During the anesthesia consultation = 1 week to 3 months after inclusion