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BJA Advance Access originally published online on August 18, 2008
British Journal of Anaesthesia 2008 101(5):640-647; doi:10.1093/bja/aen239
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© The Board of Management and Trustees of the British Journal of Anaesthesia 2008. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Influence of resident training on anaesthesia induction times

M. Schuster1,2,*, T. Kotjan1, M. Fiege1 and A. E. Goetz1

1 Department of Anaesthesiology, University Hospital Hamburg-Eppendorf, Hamburg, Germany
2 Department of Anaesthesiology and Intensive Care, Charité-Universitätsmedizin Berlin, Campus Charité Mitte and Campus Virchow Klinikum, Charitéplatz 1, 10117 Berlin, Germany

* Corresponding author. E-mail: martin.schuster{at}charite.de

Background: The effect of resident training in anaesthesiology on operating room (OR) economics is an issue of debate. Comparisons of anaesthesia process times between residents and consultants might be systematically skewed by interactions of anaesthesia technique and patient factors.

Methods: In this prospective, observational study, we analysed anaesthesia process times in 599 cases performed for four different surgical services in a University hospital. The following factors were recorded for each case and used in multivariate analyses of process times: age, American Society of Anesthesiologist (ASA) status, BMI, emergency status, the educational level of the anaesthetist, and the anaesthesia technique.

Results: In the non-adjusted comparison, only for two of seven anaesthetic techniques did resident cases have statistically significant longer induction times than consultant cases: general anaesthesia with placement of a central venous catheter [mean (SD) anaesthesia time for resident cases 38.2 (17.0) vs 22.3 (10.0) min for consultant cases, P=0.001] and general anaesthesia with a laryngeal mask airway [resident cases 11.3 (5.5) vs consultant cases 7.3 (5.0) min, P=0.003]. Anaesthetic technique had the greatest effect on anaesthesia induction time. Educational level of the anaesthetist and age of the patients had small, but significant effects.

Conclusions: Anaesthesia cases performed by residents have in some, but not in all, anaesthesia techniques increased process times compared with cases performed by consultants. This limits a possible negative impact on OR economics by resident education. Patient-based factors including ASA status, BMI, and emergency status have minimal or no effect on anaesthesia process times.

Keywords: anaesthetic techniques, induction; education; OR economics; OR efficiency; resident training


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