[Professional image of anesthetists in the general public. Influence of provision of information and previous experience with the discipline]. / Berufsbild des Anästhesisten in der Öffentlichkeit. Einfluss von Vorinformation und Vorerfahrungen mit dem Fach.

BACKGROUND: The profession of the anesthetist in Germany includes the disciplines anesthesia, intensive care, emergency and pain medicine. Despite the versatility and competence of the profession, patients do not appear to have recognized anesthesiology as a medical discipline or anesthetists as medical doctors. AIM: This study was conducted with the aim of estimating how previous experience and information gathered before contact with the anesthetist for premedication have influenced and changed the perception of patients with regards to the professional fields and the characteristics of anesthetists. MATERIAL AND METHODS: A total of 3,950 patients from 3 German hospitals were asked to answer a questionnaire handed out by the assistance nurse in the premedication area prior to the medical consultation with the duty anesthetist. The questions involved the patient perception of the discipline, the characteristics of anesthetists and also evaluated the patient previous experience and provision of information. According to the answers 1,753 patients were considered eligible for the study and were categorized into subgroups I-IV (group I interested and experienced with operations, group II interested but inexperienced, group III uninterested but experienced and group IV neither interested nor experienced) for statistical analysis. RESULTS: Of the respondents 56.2 % had obtained previous information from a general practitioner followed by acquaintances (21.4 %) and the internet (19.9 %), which significantly differed with age. Interested and experienced patients showed the best perception of the profession. Often, the knowledge of interested and uninterested persons did not significantly differ. Interested patients and those with experience of anesthesiology had the best knowledge of anesthesiology. Performing anesthesia was most often identified by all groups (50.9-95.3 %) as a function of anesthetists while the other professional fields were recognized correctly by only 5.8-26.6 %. Depending on the group 41.0-84.4 % regarded anesthetists as medical doctors. Only 15.0-78.3 % of other attributes were associated with anesthetists. CONCLUSION: Unfortunately, the perception of patients on the versatility and characteristics of anesthetists are poorly developed. However, the knowledge differs significantly depending on previous experience and gathered information. Interestingly patients with previous experience mostly showed better knowledge compared to interested patients. Results suggest that personal interaction, patient-physician communication in general and improved collaboration between general practitioners and anesthetists are the key elements for better patient knowledge, which could lead to increased patient satisfaction.

Co-stimulation with an olfactory stimulus increases arousal responses to trigeminal stimulation.

UNLABELLED: An interaction of the intranasal chemical trigeminal and the olfactory system has previously been described. Intranasal chemical trigeminal stimulation during sleep leads to a dose-dependent increase in arousal reactions while pure olfactory stimuli are not able to trigger arousals or awakenings during sleep, regardless of the concentration used. The aim of the study was to assess whether co-stimulation with an olfactory substance increases arousal responses to intranasal chemical trigeminal stimulation. EXPERIMENTAL PROCEDURES: Five young healthy, normosmic volunteers of both sexes participated in the trial and 20 nights of testing were performed. For intranasal chemical trigeminal stimulation, CO(2) was administered at 40% v/v and at 0% as a control stimulus. For olfactory co-stimulation, H(2)S was used at a concentration of 8 ppm. To compare the specific nasal chemical trigeminal/olfactory interaction with an interaction between an olfactory stimulus and peripheral somatosensory stimulation, an electrical stimulation protocol at the forearm was used with and without olfactory co-stimulation. RESULTS: Chemical trigeminal stimulation with 40% CO(2) led to an increase in arousal frequency compared to the control stimulus, which was most pronounced in light sleep. Co-stimulation with H(2)S was associated with higher arousal frequencies and shorter arousal latencies compared to isolated chemical trigeminal stimulation. The differences between the three study conditions were statistically significant for light sleep. Increasing electric stimulus concentration was associated with an increase in arousal frequency, again most pronounced in light sleep. Co-simulation with the olfactory stimulus did not lead to a systemic effect with regard to arousal reactions. CONCLUSIONS: The present results confirm the close interaction of the olfactory and chemical trigeminal system and support the idea that this interaction takes place at an early stage of processing.