Surgery risks go up depending upon the anesthesiologists workload, study suggests

Most major surgeries would not be possible without anesthesia to render a patient unconscious and pain free and to ensure that their vital functions — including blood pressure, breathing, and heart rate and rhythm — remain stable throughout the procedure.

As the demand for such surgical care grows, many clinicians, including anesthesia care teams, are being asked to take care of more patients, all while maintaining patient safety.

An anesthesia clinician — a certified registered nurse anesthetist, certified anesthesia assistant, anesthesiology resident or anesthesiologist — is continuously present in the operating room and delivering important care during every surgery requiring anesthesia. However, it is not uncommon to have one anesthesiologist directing the anesthesia care delivered by other anesthesia clinicians for multiple surgical cases at a time, according to Sachin Kheterpal, M.D. M.B.A., associate dean for Research Information Technology and professor of Anesthesiology at Michigan Medicine.

A new study appearing in JAMA Surgery from a team at the University of Michigan examines whether the number of overlapping procedures managed by the anesthesiologist increases the risk of death or complications after surgery.

Using data from the Multicenter Perioperative Outcomes Group electronic health record registry, the team investigated surgical procedures that involved an anesthesiologist directing a CRNA or an anesthesiology resident. This anesthesia care team model is the most common model used to deliver anesthesia in the United States.

Focusing their analysis on cases with CRNA involvement and minimal anesthesiology resident involvement, the authors looked at data from more than 570,000 surgical cases at 23 hospitals in the United States between 2010 and 2017.

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