Participants and baseline characteristics
A total of 314 patients for whom ambulatory dental surgery was planned were eligible for the study; of these, 299 patients were included, and 15 were excluded. The anesthesia method the patients chose was GA by 58% and MAC by 42%. After the procedure, 81.6% patients completed the questionnaire. From the GA group, 17% and from the MAC group, 21% did not complete the questionnaire. A flow diagram of the study is depicted in Additional file 1: Figure S1.
The baseline characteristics were compared between the groups, and the gender distribution did not differ (p = 0.4, Additional file 1: Table S1). The mean age of the patients in the GA group (24.7 years, [SD] ± 14.2) was lower than that of the patients in the MAC group (33.5 years, SD ± 19.1) (p = 0.005, Additional file 1: Table S1). Those in the GA group underwent fewer third molar extractions (n = 115, 79.9%) than in the MAC group (n = 66, 66%), as the latter underwent more primarily implant surgery and other extractions (p = 0.03, Additional file 1: Table S1).
Patient satisfaction with the procedure
All mean satisfaction scores ranged between “satisfied” (score 3) and “very satisfied” (score 4) in both groups (Fig. 1). Patients in the MAC group were, however, more satisfied (mean score 3.84) with the care provided by the department of anesthesia in general compared to the GA group (mean score 3.75) (p = 0.015). Patients were equally satisfied in both groups regarding the information given before the operation ((p = 0.937), emergence from anesthesia (p = 0.140), analgetic (p = 0.687), and treatment of nausea and vomiting (p = 0.670) (Additional file 1: Table S2, Fig. 1).
Anesthesia-related discomfort
When asked about anesthesia-related discomfort, 75% of patients in the MAC group reported more severe or moderate drowsiness compared to the 59% in the GA group (p = 0.048, Fig. 2A). In contrast, patients in the GA group had more postoperative hoarseness and sore throat than those in the MAC group (p = 0.005 and p < 0.001, respectively) (Fig. 2B and C). Also, postoperative thirst was more common in the GA group, with 15% of the GA group reporting severe thirst compared to 3% in the MAC group (p = 0.002) (Fig. 2D). All results of the univariate and multivariate analyses are shown in Additional file 1: Table S3.
The worst aspect of the procedure
When asked what the worst aspect of the anesthetic procedure was, the most common answer was 'fear' in both groups, as 31% of patients in the GA group and 27% in the MAC group reported this. This was followed by 'not being able to do daily activities' in 22% of the GA group, and 'the recovery process' in 21% of the MAC group. (Additional file 1: Figure S2).
Awareness during the procedure
When asked whether the patients could remember anything from the period between falling asleep and awakening, there was a notable difference between the two groups. Almost everyone (n = 140, 98%) in the GA group had complete amnesia as they remembered nothing, while this was only 17% in the MAC group. In the MAC group, 50% reported painless sensations, and 13% of the patients perceived pain. However, only one of the patients undergoing MAC reported fear or stress during the procedure (Fig. 3).