General anesthesia is a critical component of modern surgical practice, ensuring pain relief, unconsciousness, and immobility during surgical procedures. Despite its widespread use and advancements in anesthetic techniques, there remains a significant gap in public knowledge regarding its purpose, risks, benefits, and potential complications. Misinformation or lack of awareness can lead to increased preoperative anxiety, misconceptions, and reduced trust in medical professionals, ultimately affecting patient cooperation and surgical outcomes. Understanding the general public’s knowledge of anesthesia is essential for improving patient education and enhancing their perioperative experience.[1-4]

Kangra, one of the largest districts in Himachal Pradesh, presents a unique setting to assess public awareness of general anesthesia. The region’s demographic diversity, encompassing both urban and rural populations, contributes to varying levels of healthcare access and literacy. While urban areas may benefit from better healthcare infrastructure and exposure to medical information, rural populations often face barriers such as limited resources, lower literacy rates, and cultural beliefs that may influence their understanding and perceptions of medical procedures, including anesthesia. These disparities highlight the need to assess the existing knowledge base to identify gaps and implement targeted educational interventions.

Studies indicate that inadequate awareness of general anesthesia can lead to unrealistic expectations, heightened preoperative anxiety, and reluctance to consent to necessary surgical interventions.[5-8] Public misconceptions surrounding the safety, duration, and postoperative effects of anesthesia further emphasize the need for effective communication and education from healthcare providers. In resource-limited settings like Kangra, where access to anesthesiologists may be restricted, enhancing public knowledge becomes even more crucial to ensure better healthcare outcomes.

This study aims to evaluate the level of awareness and knowledge about general anesthesia among the residents of Kangra district, Himachal Pradesh. By identifying gaps in understanding, the findings can guide the development of educational programs and communication strategies to foster informed decision-making, alleviate fears, and improve patient engagement in their surgical care. The research also seeks to explore the influence of socio-demographic factors such as age, education, and occupation on public knowledge, enabling healthcare authorities to tailor interventions to specific population groups.

Research Design

This study employed a descriptive, cross-sectional design to assess the awareness and knowledge of general anesthesia among the general public in Kangra district, Himachal Pradesh. An online questionnaire-based survey was conducted to systematically evaluate public understanding, perceptions, and common misconceptions related to general anesthesia.

Study Area

The study focused on Kangra district, Himachal Pradesh, covering both urban and rural populations. The online nature of the survey allowed for broad participation across different socio-demographic groups, ensuring comprehensive representation of the region.

Study Duration

The study was conducted over a period of three months, from August to October 2024, allowing ample time for data collection and participant engagement.

Study Population

The target population included adult residents of Kangra district (aged 18 years and above) who had internet access and were able to comprehend the survey questions. Efforts were made to ensure representation from diverse educational, occupational, and income backgrounds.

Sample Size

A total of 400 participants were recruited for the study. The sample size was calculated using a 95% confidence level, an estimated 50% awareness level of general anesthesia, and a 5% margin of error. An additional 5% was included to account for potential non-responses.

Sampling Technique

A convenience sampling method was employed using online platforms such as social media (Facebook, WhatsApp, Instagram), email groups, and community forums to reach a broad audience.

Inclusion Criteria

• Individuals aged 18 years and above.

• Residents of Kangra district for at least one year.

• Access to the internet and the ability to read and respond to the survey.

• Willing to provide informed consent.

Exclusion Criteria

• Individuals with a medical or paramedical background to avoid bias in knowledge assessment.

• Non-consenting individuals.

• Incomplete survey responses.

Study Tool

A structured, pre-validated online questionnaire was used for data collection. The questionnaire was developed with input from anesthesiology and public health experts and was provided in both English and Hindi for accessibility.

The questionnaire comprised two sections:

1. Socio-Demographic Information:

• Data on participants' age, gender, education level, occupation, income, and place of residence.

• A total of 20 multiple-choice and true/false questions covering topics such as:

  • Definition and purpose of general anesthesia.

  • Risks and side effects.

  • Preoperative and postoperative care.

  • The role of anesthesiologists.

  • Common misconceptions about anesthesia.

1. Knowledge and Awareness Assessment:

Scoring was based on the number of correct responses:

• Very Good Knowledge: ≥80% correct responses.

• Good Knowledge: 60%–79% correct responses.

• Fair Knowledge: 41%–59% correct responses.

• Poor Knowledge: <40% correct responses.

Data Collection Procedure

The survey was distributed online using Google Forms and shared through various social media platforms and local community groups to maximize reach. Participants were encouraged to share the survey link within their networks to enhance response rates. A brief introductory message accompanied the survey link, explaining the study's purpose, ensuring voluntary participation, and requesting honest responses.

Data Analysis

The collected data were downloaded from Google Forms and analyzed using Microsoft Excel and Epi Info V7 software. Descriptive statistics, including frequencies and percentages, were used to summarize demographic characteristics and knowledge levels. Chi-square tests were applied to examine associations between socio-demographic factors and knowledge levels, with a significance level set at p < 0.05.

Ethical Considerations

Participation was voluntary, and informed consent was obtained electronically at the beginning of the survey. Confidentiality and anonymity were strictly maintained, and participants were informed that they could withdraw from the study at any time without consequences.

A total of 400 participants completed the online survey, providing insights into the awareness and knowledge of general anesthesia among the general public in Kangra district, Himachal Pradesh. The following tables summarize the socio-demographic characteristics of the participants, their awareness and knowledge levels, and the overall knowledge score classification.

Table 1: Socio-Demographic Characteristics of Study Participants

The socio-demographic profile of the study participants provides valuable insights into the diversity of the sample population in Kangra district. Of the 400 respondents, 52.8% were female and 47.2% were male, reflecting a balanced gender distribution. The largest age group (36.0%) fell within the 26–35 years category, followed by those aged 36–45 years (25.5%), indicating that the majority of respondents were in their prime working and reproductive years. Educational levels varied, with 30.0% holding undergraduate degrees and 27.5% having completed secondary school, while 10.0% reported having no formal education, emphasizing the need for tailored educational interventions. The majority of participants (32.0%) were engaged in private or government services, followed by agriculture/labor (27.0%) and homemaking (23.0%). In terms of financial status, 38.0% reported a monthly household income between INR 10,001–20,000, while 24.0% earned below INR 10,000, highlighting the economic diversity within the region and potential financial barriers to healthcare access.

Table 2: Awareness and Knowledge Assessment of General Anesthesia

The awareness and knowledge assessment of general anesthesia among respondents revealed a mixed level of understanding. Encouragingly, 77.5% of participants correctly identified the primary purpose of general anesthesia as inducing unconsciousness, while 85.5% recognized that anesthesiologists, rather than surgeons or nurses, administer anesthesia. However, only 62.0% were aware that patients might rarely wake up during surgery, indicating gaps in understanding potential risks. Questions related to preoperative requirements, such as fasting (74.5%), and potential complications (80.5%) had relatively high correct response rates, reflecting some awareness of essential procedural aspects. Nonetheless, responses to questions about post-anesthesia recovery, such as how long it takes to wear off (69.0%) and whether it can be reversed immediately (64.5%), demonstrated the need for further public education. The study results emphasize the importance of increasing awareness regarding the safety, monitoring, and procedural intricacies of anesthesia to dispel misconceptions and enhance preparedness for medical procedures.

Table 3: Knowledge Score Classification

The knowledge score classification indicates that while a significant proportion of participants (36.0%) demonstrated a "Good" level of knowledge, achieving scores between 12–15, only 26.0% fell into the "Very Good" category with scores between 16–20. A considerable 28.0% of respondents were classified under the "Fair" category, suggesting moderate knowledge levels with room for improvement. Alarmingly, 10.0% of participants had "Poor" knowledge scores, underscoring a critical need for targeted educational interventions to improve public understanding of general anesthesia. These findings suggest that while a foundational awareness exists within the community, there is still substantial scope for enhancing public knowledge through awareness programs, public health campaigns, and healthcare provider engagements to ensure informed decision-making and reduced anxiety regarding surgical procedures.

The findings of this study provide a comprehensive understanding of public knowledge and awareness regarding general anesthesia in Kangra, Himachal Pradesh. The results indicate a varied level of awareness, with significant gaps in understanding the roles, risks, and procedures associated with general anesthesia. These findings highlight the importance of targeted educational interventions to bridge the knowledge gaps and equip individuals with accurate information to make informed decisions about their healthcare.

The socio-demographic characteristics of the study participants reflect a diverse sample, with a balanced gender distribution and a predominant age group of 26–35 years (36.0%), followed by 36–45 years (25.5%). This suggests that the majority of respondents are in their prime years, likely to require surgical interventions at some stage in their lives. The varied educational levels, with 30.0% holding undergraduate degrees and 27.5% with secondary school education, highlight a relatively educated population. However, the presence of 10.0% of participants with no formal education underscores the need for health literacy programs tailored to different educational backgrounds. The occupational profile, with the largest proportion engaged in private or government service (32.0%) and agriculture (27.0%), suggests that public health campaigns must consider the working schedules and accessibility of such populations. Furthermore, the financial profile of respondents, where 38.0% earn between INR 10,001–20,000 monthly, indicates that affordability of healthcare services might influence perceptions and preparedness regarding anesthesia procedures.

The awareness assessment demonstrated a reasonable baseline understanding of general anesthesia, with 77.5% of participants correctly identifying its primary purpose as inducing unconsciousness for surgical procedures. Additionally, 85.5% of respondents were aware that anesthesiologists, rather than surgeons or nurses, are responsible for administering anesthesia, indicating recognition of the specialized role these medical professionals play. However, knowledge gaps were evident in areas such as understanding the possibility of intraoperative awareness, where only 62.0% acknowledged its potential occurrence. This reveals a need for public education on the rare but possible risks of anesthesia and the measures taken to mitigate them.

Moreover, the findings show that while 74.5% of participants understood the importance of preoperative fasting, there remains a significant proportion who might not be fully aware of why fasting is crucial to prevent complications like aspiration during surgery. The post-anesthesia recovery process also emerged as a knowledge gap, with only 69.0% understanding the typical duration of anesthetic effects and 64.5% aware that anesthesia can be reversed under medical supervision. These gaps could lead to misconceptions, unrealistic expectations, and increased anxiety among patients undergoing surgical procedures. Addressing these areas through educational initiatives can significantly enhance patient preparedness and compliance with pre- and post-surgical instructions.

The knowledge classification results provide further insight into the overall awareness levels among the public. While 26.0% of respondents demonstrated a "Very Good" understanding of general anesthesia, the majority (36.0%) fell into the "Good" category, suggesting a foundational awareness but with considerable room for improvement. The presence of 28.0% in the "Fair" category and 10.0% in the "Poor" category is concerning, indicating that nearly 40% of the population has insufficient knowledge about general anesthesia. This lack of awareness could contribute to misconceptions, non-compliance with medical advice, and heightened anxiety before surgical procedures.

Individuals with poor knowledge may be more susceptible to myths and misinformation, potentially leading to reluctance or fear regarding surgical interventions requiring anesthesia. These findings highlight the urgent need for awareness campaigns through community health initiatives, social media platforms, and direct engagement with healthcare professionals. Empowering individuals with accurate knowledge can foster trust in the healthcare system and improve overall surgical outcomes.[9,10]

Recommendations for Improving Public Awareness

To address the knowledge gaps identified in this study, a multi-faceted approach is required to improve public understanding of general anesthesia. Key recommendations include:[11-14]

1. Community Health Education Programs: Conducting regular workshops and informational sessions in collaboration with local healthcare facilities can help dispel myths and enhance public confidence in anesthesia procedures.

2. Digital Outreach: Utilizing social media platforms, websites, and mobile applications to provide easy-to-understand, visually appealing educational content can reach a larger audience and engage younger populations.

3. Healthcare Provider Engagement: Encouraging anesthesiologists and healthcare professionals to proactively educate patients during preoperative consultations can help address individual concerns and improve compliance with medical advice.

4. School and Workplace Awareness Campaigns: Integrating basic knowledge about surgical procedures, including anesthesia, into school curricula and workplace health programs can improve overall health literacy.

5. Printed Educational Materials: Distributing pamphlets and brochures in local languages at hospitals, community centers, and pharmacies can serve as a valuable resource for individuals with limited digital access.

Limitations of the Study

As the study was conducted online, participation was limited to individuals with internet access, potentially excluding those from lower socio-economic backgrounds or remote areas without digital connectivity. Additionally, self-reported responses may be influenced by social desirability bias.

This study highlights the existing gaps in public awareness and understanding of general anesthesia among the residents of Kangra, Himachal Pradesh. While a substantial portion of the population possesses basic knowledge, critical gaps persist regarding procedural risks, preoperative preparation, and postoperative care. Addressing these gaps through targeted educational initiatives, community engagement, and digital outreach is essential to enhance public understanding, alleviate preoperative anxiety, and improve surgical outcomes. Strengthening awareness efforts will empower individuals to make informed decisions, foster trust in healthcare providers, and contribute to better perioperative experiences.

The authors declare that they have no conflict of interest

No funding sources

The study was approved by the Civil Hospital, Kangra (Himachal Pradesh)

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