Journal article
Prolonged tracheal extubation time after glioma surgery was associated with lack of familiarity between the anesthesia provider and the operating neurosurgeon. A retrospective, observational study
Journal of Clinical Anesthesia, Vol.60, pp.118-124
03/2020
DOI: 10.1016/j.jclinane.2019.09.003
PMID: 31669746
Abstract
We consider the effect of the number of previous interactions between the anesthesia provider and a single neurosurgeon during neurosurgical procedures (“familiarity”) and occurrence of an interval ≥15 min from the end of surgery (i.e., dressings applied) to tracheal extubation (“prolonged extubation”) during subsequent glioma procedures by that neurosurgeon. The value of 15min is a threshold at which post-case activity by non-anesthesia personnel in the operating room ends. Historical observational study. Neurosurgical operating room suite in an academic teaching hospital. 294 patients undergoing elective supratentorial glioma surgery between 2012 and 2017 by a single neurosurgeon. 1) Time from end of surgery (“dressings applied”) to extubation; 2) number of previous cases where the anesthesia provider had been present at the end of a neurosurgical procedure performed by the neurosurgeon; 3) case duration. Anesthesia providers (nurse anesthetists or anesthesia residents) were considered “unfamiliar” with the neurosurgeon if they had been present at the time of extubation for <5 previous neurosurgical cases (including glioma and non-glioma surgery) performed by the neurosurgeon during the study interval. For approximately half the cases the anesthesia provider was unfamiliar with the neurosurgeon. There was an association between the provider's number of historical cases with the neurosurgeon and prolonged extubation (P = 0.0048); the adjusted odds ratio (by unadjusted logistic regression) for unfamiliarity was 2.10 (95% CI 1.28 to 3.44, P = 0.025). Consistent with previously shown associations between case duration and prolonged extubation, analyses were valid based on a near-linear relationship between the logit (prevalence of prolonged extubation) and the case duration quintile. Lack of familiarity between the anesthesia provider and neurosurgeon during previous anesthetics is associated with prolonged tracheal extubation following intracranial glioblastoma surgery. •Studied 294 patients undergoing elective glioblastoma surgery by one neurosurgeon.•Prolonged extubation occurred if ≥15 min after the end of surgery.•Unfamiliarity defined as <5 prior cases by the anesthetist-neurosurgeon pair•Prolonged extubation was associated with unfamiliarity.•Longer cases were also more likely to be associated with prolonged extubation.
Details
- Title: Subtitle
- Prolonged tracheal extubation time after glioma surgery was associated with lack of familiarity between the anesthesia provider and the operating neurosurgeon. A retrospective, observational study
- Creators
- Richard H Epstein - Department of Anesthesiology, Pain Management and Perioperative Medicine, University of Miami, 1400 NW 12th Avenue, Suite 3075, Miami, FL 33136, United States of AmericaFranklin Dexter - Division of Management Consulting, Department of Anesthesia, University of Iowa, 200 Hawkins Drive, 6-JCP, Iowa City, IA 52242, United States of AmericaIahn Cajigas - Department of Neurological Surgery, University of Miami, Miller School of Medicine, 1475 NW 12th Ave, Miami, FL, 33136, United States of AmericaAnil K Mahavadi - Department of Neurological Surgery, University of Miami, Miller School of Medicine, 1475 NW 12th Ave, Miami, FL, 33136, United States of AmericaAshish H Shah - Department of Neurological Surgery, University of Miami, Miller School of Medicine, 1475 NW 12th Ave, Miami, FL, 33136, United States of AmericaNathalie Abitbol - Department of Anesthesiology, Pain Management and Perioperative Medicine, University of Miami, 1400 NW 12th Avenue, Suite 3155, Miami, FL 33136., United States of AmericaRicardo J Komotar - Department of Neurological Surgery, University of Miami, Miller School of Medicine, 1475 NW 12th Ave, Miami, FL, 33136, United States of America
- Resource Type
- Journal article
- Publication Details
- Journal of Clinical Anesthesia, Vol.60, pp.118-124
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.jclinane.2019.09.003
- PMID
- 31669746
- ISSN
- 0952-8180
- eISSN
- 1873-4529
- Language
- English
- Date published
- 03/2020
- Academic Unit
- Health Management and Policy; Anesthesia
- Record Identifier
- 9983983623002771
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