Patient-Reported Concerns and Factors Associated With Anesthetic Preference: A Cross-Sectional Study on Why Patients Choose General Over Regional Anesthesia
- 1Department of Anesthesiology, General Hospital of Ioannina "G. Hatzikosta", Ioannina, GRC
Abstract
Background
Regional anesthesia (RA) offers established perioperative benefits, yet many patients choose general anesthesia (GA) even when RA is a clinically appropriate option. Understanding patients' specific concerns and other factors associated with anesthetic preference may help improve patient-centered preoperative communication and shared decision-making.
Methods
This cross-sectional, questionnaire-based study included 276 adult patients scheduled for elective surgery at a public general hospital in Greece. Before preoperative anesthetic consultation, participants reported their anesthetic preference, previous RA experience, and sociodemographic and clinical characteristics. Patients who preferred GA identified their concerns regarding RA from 11 predefined items. Factors independently associated with anesthetic preference were assessed using multivariable binary logistic regression.
Results
Of 350 eligible patients invited, 276 completed the survey (response rate = 78.9%); 65.9% (n = 182) preferred GA and 34.1% (n = 94) preferred RA. Male sex (odds ratio {OR} = 7.12; 95% confidence interval {CI}: 3.13-16.22; p < 0.001) and previous RA experience (OR = 3.50; 95% CI: 1.70-7.19; p = 0.001) were independently associated with RA preference. Surgical specialty, education, and employment status were also independently associated with anesthetic preference. Among patients preferring GA (n = 182), the most frequently reported concerns were hearing events during surgery (90.1%, n = 164), seeing the procedure (77.5%, n = 141), and experiencing intraoperative pain (73.1%, n = 133). Concerns about permanent paralysis (40.7%, n = 74) and back injury (40.1%, n = 73) were less frequent. Among respondents to the information-related items (n = 202), 31.2% (n = 63) reported having heard that RA could cause complications, most commonly from relatives (66.7%, n = 42), while 95.5% (n = 193) wanted their anesthesiologist to address their questions about RA.
Conclusions
GA was preferred by approximately two-thirds of elective surgical patients despite RA being a clinically viable option. The leading concerns regarding RA centered on the awareness of the surgical environment and intraoperative pain rather than rare neurological complications. Anesthetic preference was also independently associated with previous RA experience and several patient characteristics. Identifying and directly addressing these concerns during preoperative counseling may support more informed and individualized anesthetic decision-making.
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BibTeX
@article{mavridou2026patientreported,
title = {{Patient-Reported Concerns and Factors Associated With Anesthetic Preference: A Cross-Sectional Study on Why Patients Choose General Over Regional Anesthesia}},
author = {Paraskevi Mavridou and Pinelopi Kitsakou and Panagiota Panagiotou and Christos Exarchos and Chrysoula Antigoni Koutsi and Athina Stratsiani and Marina Gkegka},
journal = {Cureus},
year = {2026},
month = sep,
doi = {10.7759/cureus.117201},
url = {https://europepmc.org/article/PMC/PMC13720936},
note = {CC BY},
}
RIS
TY - JOUR
TI - Patient-Reported Concerns and Factors Associated With Anesthetic Preference: A Cross-Sectional Study on Why Patients Choose General Over Regional Anesthesia
AU - Paraskevi Mavridou
AU - Pinelopi Kitsakou
AU - Panagiota Panagiotou
AU - Christos Exarchos
AU - Chrysoula Antigoni Koutsi
AU - Athina Stratsiani
AU - Marina Gkegka
PY - 2026
DA - 2026/09/30
JO - Cureus
DO - 10.7759/cureus.117201
UR - https://europepmc.org/article/PMC/PMC13720936
AB - Background Regional anesthesia (RA) offers established perioperative benefits, yet many patients choose general anesthesia (GA) even when RA is a clinically appropriate option. Understanding patients' specific concerns and other factors associated with anesthetic preference may help improve patient-centered preoperative communication and shared decision-making. Methods This cross-sectional, questionnaire-based study included 276 adult patients scheduled for elective surgery at a public general hospital in Greece. Before preoperative anesthetic consultation, participants reported their anesthetic preference, previous RA experience, and sociodemographic and clinical characteristics. Patients who preferred GA identified their concerns regarding RA from 11 predefined items. Factors independently associated with anesthetic preference were assessed using multivariable binary logistic regression. Results Of 350 eligible patients invited, 276 completed the survey (response rate = 78.9%); 65.9% (n = 182) preferred GA and 34.1% (n = 94) preferred RA. Male sex (odds ratio {OR} = 7.12; 95% confidence interval {CI}: 3.13-16.22; p < 0.001) and previous RA experience (OR = 3.50; 95% CI: 1.70-7.19; p = 0.001) were independently associated with RA preference. Surgical specialty, education, and employment status were also independently associated with anesthetic preference. Among patients preferring GA (n = 182), the most frequently reported concerns were hearing events during surgery (90.1%, n = 164), seeing the procedure (77.5%, n = 141), and experiencing intraoperative pain (73.1%, n = 133). Concerns about permanent paralysis (40.7%, n = 74) and back injury (40.1%, n = 73) were less frequent. Among respondents to the information-related items (n = 202), 31.2% (n = 63) reported having heard that RA could cause complications, most commonly from relatives (66.7%, n = 42), while 95.5% (n = 193) wanted their anesthesiologist to address their questions about RA. Conclusions GA was preferred by approximately two-thirds of elective surgical patients despite RA being a clinically viable option. The leading concerns regarding RA centered on the awareness of the surgical environment and intraoperative pain rather than rare neurological complications. Anesthetic preference was also independently associated with previous RA experience and several patient characteristics. Identifying and directly addressing these concerns during preoperative counseling may support more informed and individualized anesthetic decision-making.
SN - 2168-8184
ER -