Anesthesia and analgesia最新文献_第2页

Remote Hands-on Training versus On-site Hands-on Training for Flexible Optical Intubation: A Noninferiority Randomized Controlled Trial.

IF 4.6 2区医学

Anesthesia and analgesia Pub Date : 2025-03-31 DOI: 10.1213/ANE.0000000000007491

Danyun Fu, Wei Wei, Dingding Wang, Yilei Shen, Lili Feng, Hongjun Liu, Li Wei, Lars Konge, Yuan Han, Shuangshuang Li, Wenxian Li

{"title":"Remote Hands-on Training versus On-site Hands-on Training for Flexible Optical Intubation: A Noninferiority Randomized Controlled Trial.","authors":"Danyun Fu, Wei Wei, Dingding Wang, Yilei Shen, Lili Feng, Hongjun Liu, Li Wei, Lars Konge, Yuan Han, Shuangshuang Li, Wenxian Li","doi":"10.1213/ANE.0000000000007491","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007491","url":null,"abstract":"Background: Simulation-based training for flexible optical intubation (FOI) is effective but costly and often unavailable in remote areas. Online, hands-on training using affordable, shippable models could be a feasible alternative.Methods: In this noninferiority randomized controlled trial, 30 participants with fewer than 5 FOI experiences were assigned randomly to either remote or on-site hands-on training groups at a 1:1 ratio. The remote group received online theoretical teaching and supervised training and hands-on practice using a modified \"Choose-the-Hole\" model and a three-dimensional (3D)-printed airway manikin shipped to them. The on-site group received theoretical teaching and hands-on FOI practice in the Eye & ENT Hospital Training Center. Within 1 week after training, all participants performed the FOIs on anesthetized patients with normal airway anatomy. The performances were video recorded and evaluated. The primary outcome was the global rating scale (GRS) scores of the FOI performance on the patient. Secondary outcomes included the checklist scores of FOI performance, first attempt and total success rate, mean intubation time, self-assessment, and training satisfaction.Results: From July 2022 to December 2022, 30 participants were randomly assigned to receive either remote training (n = 15) or on-site training (n = 15), of whom 28 participants were included in the analyses (17 females, 11 males, average age of 30.0 years). The baseline characteristics of the participants were comparable between 2 groups. No significant difference was found in GRS scores (14.2 ± 3.95 vs. 12.0 ± 3.60, P = .146, mean difference, 2.14, 95% confidence interval [CI], -0.79 - 5.08) between the remote and on-site groups. Statistically similar mean checklist scores (9.32 ± 0.78 vs. 8.89 ± 1.08, P = .238) and intubation time (123 ± 68 vs. 117 ± 54 seconds, P = .780) were noted, respectively, in the remote and on-site groups. The total success rate was 100% in both groups. No significant difference was found in the remote and on-site groups regarding self-assessment and training satisfaction scores.Conclusions: Remote FOI hands-on training using shippable models was as effective as on-site training, with similar performance, checklist scores, success rate, and intubation time. This suggests that remote training can serve as a viable, cost-effective alternative to traditional on-site methods.","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143750719","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ecodesign in Health Care: Reducing Environmental, Economic, and Social Impacts: A Case Study on Venous Port Insertion.

IF 4.6 2区医学

Anesthesia and analgesia Pub Date : 2025-03-27 DOI: 10.1213/ANE.0000000000007513

Laure Bonnet, Frédéric Berthier, Jean Catineau, Anne Forestier, Jane Muret

引用次数: 0

Anesthesiology Resident Demographics and the BASIC Examination Pass Rates.

IF 4.6 2区医学

Anesthesia and analgesia Pub Date : 2025-03-27 DOI: 10.1213/ANE.0000000000007490

Huaping Sun, Ann E Harman, John D Mitchell, Robert R Gaiser, Stacie G Deiner

{"title":"Anesthesiology Resident Demographics and the BASIC Examination Pass Rates.","authors":"Huaping Sun, Ann E Harman, John D Mitchell, Robert R Gaiser, Stacie G Deiner","doi":"10.1213/ANE.0000000000007490","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007490","url":null,"abstract":"Background: The BASIC Examination was added to the US examination system for anesthesiology certification in 2014. The American Board of Anesthesiology conducted retrospective analyses to assess whether resident demographics, program characteristics, and/or prior examination performance were associated with first-time BASIC pass rates.Methods: Anesthesiology residents who took the BASIC Examination for the first time from July 2014 to November 2022 were eligible to participate, and they had at least 2 more attempts (or opportunities to attempt) through December 2023. First-time and eventual pass rates (ie, based on up to 3 attempts) were calculated for each demographic group. For those residents who had the clinical base year in-training examination (CBY ITE) scores available, demographic group performance differences on this examination were first examined. Mixed-effects logistical regression models assessed how resident demographics, program characteristics, and/or prior CBY ITE scores were associated with the odds of passing the BASIC the first time.Results: The analyses included 17,286 examination attempts from 15,789 residents. The majority of residents were male (65.8%), non-Hispanic or Latino (76.2%), White (47.8%), and US medical school graduates (87.4%). Differences in the first-attempt BASIC pass rates included male (92.7%) vs female (88.1%), non-Hispanic or Latino (92.0%) vs Hispanic or Latino (85.8%), Asian (92.6%) and White (92.4%) vs Black/African American (81.9%), respectively, and US (91.5%) vs international (88.6%) medical school graduates. Females had significantly lower odds of passing the BASIC the first time than males (odds ratio [OR] = 0.53, 95% confidence interval [CI], 0.47-0.60); Black/African American residents (OR = 0.41, 95% CI, 0.33-0.51) and Middle Eastern or North African residents (OR = 0.64, 95% CI, 0.46-0.91) had lower odds of passing the BASIC on first attempt than White residents; Hispanic or Latino residents had lower odds of passing the BASIC initially than non-Hispanic or Latino residents (OR = 0.52, 95% CI, 0.42-0.64). Nevertheless, all demographic subgroups' eventual pass rates were >99%.Male and White residents outperformed female and Black/African American residents, respectively, in CBY ITEs. The gender and race performance gaps in the first-time BASIC pass rates were attenuated but not eliminated after controlling for their CBY ITE scores-compared to male and White residents, respectively, the odds of passing the BASIC the first time changed from 46% to 56% for female residents, and from 41% to 53% for Black/African American residents.Conclusions: Female and nonwhite residents had lower first-time BASIC Examination pass rates. Almost all trainees passed by their up-to-third attempts. Future studies are needed to understand the basis of these differences and identify opportunities for improvement.","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Phenotyping the Transfusion Management Experience of Trainees Using Electronic Health Records.

IF 4.6 2区医学

Anesthesia and analgesia Pub Date : 2025-03-27 DOI: 10.1213/ANE.0000000000007477

Matthew D Caldwell, Norah N Naughton, Sathish S Kumar, Michael R Mathis, Douglas Colquhoun, Graciela B Mentz, Yuan Yuan, Lara Zisblatt

{"title":"Phenotyping the Transfusion Management Experience of Trainees Using Electronic Health Records.","authors":"Matthew D Caldwell, Norah N Naughton, Sathish S Kumar, Michael R Mathis, Douglas Colquhoun, Graciela B Mentz, Yuan Yuan, Lara Zisblatt","doi":"10.1213/ANE.0000000000007477","DOIUrl":"https://doi.org/10.1213/ANE.0000000000007477","url":null,"abstract":"Background: Clinical experience is foundational to graduate medical education but is difficult to quantify. Self-reported case logs and scheduled rotations provide limited detail on residents' actual experiences. The analysis of electronic health record (EHR) data may provide a more comprehensive view of residents' actual clinical experiences. We aimed to quantify and characterize residents' direct clinical experiences with intraoperative transfusion management as a proof of concept for the utility of EHR data in anesthesiology graduate medical education.Methods: This retrospective observational study aimed to measure the participation of anesthesiology residency graduates with intraoperative transfusion management at a single institution. Data pertaining to the University of Michigan cases submitted to the Multicenter Perioperative Outcomes Group (MPOG) data registry from January 1, 2012, to December 31, 2022, were analyzed. The primary outcome was participation in intraoperative transfusion management defined by the transfusion of any volume of homologous packed red blood cells (pRBC) documented within the intraoperative anesthesia record. Subgroup analysis characterized resident participation in severe intraoperative hemorrhage resuscitation defined as the transfusion of ≥4 pRBCs. Additional outcomes were participation in non-pRBC blood product transfusion and transfusion of cell-salvaged blood. Surgical case and resident-specific factors were analyzed for association with resident participation in intraoperative pRBC transfusion.Results: Throughout the study period, 231 residents from 8 graduating cohorts were involved in 222,006 anesthetic cases of which 8529 (4%) included intraoperative pRBC transfusion. Over the entire course of residency training, residents on average participated in 37 (standard deviation [SD] = 8) cases with intraoperative pRBC transfusion with a range of 16 to 60. The mean (SD [range]) participation with severe hemorrhage resuscitation was 10 (3 [2-22]), participation with non-pRBC transfusion was 7 (3 [1-14]), and participation with cell salvaged blood was 13 (4 [3-26]). Five of 19 surgical services (cardiac, transplant, vascular, neurosurgery, orthopedic) accounted for the majority (5668; 66%) of intraoperative transfusion management experiences.Conclusions: Variation exists in the transfusion management experience among trainees at a single academic center. This study supports the feasibility of using EHR data to quantify the clinical experiences of residents beyond the assumptions underlying self-reported case logs and time on specialty rotations. Such analyses may allow for interventions to optimize the frequency, timing, and sequencing of clinical care activities to ensure optimal clinical experience.","PeriodicalId":7784,"journal":{"name":"Anesthesia and analgesia","volume":" ","pages":""},"PeriodicalIF":4.6,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143727565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Valar Morghulis ("All Men Must Die"): Anesthesiologists' Familiarity With Recommendations for Management of Do Not Resuscitate Orders.

IF 4.6 2区医学

Anesthesia and analgesia Pub Date : 2025-03-25 DOI: 10.1213/ANE.0000000000007517

Richard P Dutton

引用次数: 0

Is There a Better Timing for Frontal Electroencephalogram Alpha Band Power Quantification to Predict Delirium After Cardiac Surgery?

IF 4.6 2区医学

Anesthesia and analgesia Pub Date : 2025-03-25 DOI: 10.1213/ANE.0000000000007492

Marie-Hélène Lagios, Thomas Bidoul, Mona Momeni, Céline Khalifa

引用次数: 0

Cricothyroid Membrane Vasculature: An Ultrasonographic Analysis.

IF 4.6 2区医学

Anesthesia and analgesia Pub Date : 2025-03-25 DOI: 10.1213/ANE.0000000000007498

Ronny Munoz-Acuna, Nicholas Cormier, Theo Yonn-Brown, Peter Cheng, William Rosenblatt

引用次数: 0

In Response.

IF 4.6 2区医学

Anesthesia and analgesia Pub Date : 2025-03-25 DOI: 10.1213/ANE.0000000000007503

Abhijit V Lele, Emily A Vail, Vikas N O'Reilly-Shah, Xinyao deGrauw, Karen B Domino, Andrew M Walters, Christine T Fong, Courtney Gomez, Bhiken I Naik, Makoto Mori, Robert Schonberger, Ranjit Deshpande, Robert E Freundlich, Michael R Mathis, Jill Mhyre, Michael J Souter

引用次数: 0

Anesthesia-Specific Data in Brain-Dead Donors?

IF 4.6 2区医学

Anesthesia and analgesia Pub Date : 2025-03-25 DOI: 10.1213/ANE.0000000000007502

Evan G Pivalizza

引用次数: 0

Are Anesthesiologists Prepared to Manage Patients With Critical Cardiac Disease?

IF 4.6 2区医学

Anesthesia and analgesia Pub Date : 2025-03-25 DOI: 10.1213/ANE.0000000000007488

Abimbola O Faloye, Beth Ladlie, Jochen D Muehlschlegel, Linda Shore-Lesserson, Christopher A Troianos, Adam J Milam

引用次数: 0