Can the Attending Anesthesiologist Accurately Predict the Duration of Anesthesia Induction?

Abstract

In a prospective, observational study, the attending anesthesiologists' prediction of anesthesia release time (ART) of the patient to the surgical team was highly correlated with actual ART (r = 0.77; P < or = 0.001). However, this was true only in the aggregate (n = 1265 patients). Indeed, offsetting degrees of under- and over-predicting (24% each) reduced accuracy to only 53% per individual case. For example, under-prediction was associated with ASA physical status IV, a regional anesthetic technique, age >65 yr, and the use of invasive hemodynamic monitoring (P = 0.006). In fact, as the degree of case difficulty increased, the correlation coefficient between predicted and actual ART decreased, indicating a poor predictive value with more difficult inductions (r = 0.82 to r = 0.44; P < or = 0.004). We conclude that knowledge of the presence of specific factors that lead to inaccurate predictions of time required for induction of anesthesia may enhance the accuracy of the operating room schedule.

Predicting the duration of surgery and procedures in a veterinary referral center

“…Ehrenwerth et al reported that attending anesthesiologists predicted the duration of anesthesia release time (time taken to prepare a patient for surgery) within 5 minutes of the actual duration only 53% of the time, with similar proportions of underestimation and overestimation (mean 10.5 and 12.4 minutes, respectively). While the data from the Ehrenwerth et al study include the time before induction of general anesthesia (which was not measured in our study), it illustrates the difficulties associated with predicting complex, multistep processes. Another study documented large variations in time spent on procedures before and after similar surgeries .…”

“…Operating rooms (OR) are expensive and limited resources, justifying optimization of their use . Accurate predictions of procedure durations improves OR scheduling and reduces overtime costs, equipment turnover, and wait times for surgeons and patients while increasing surgery throughput and revenues . Although OR scheduling occurs on a smaller scale in veterinary hospitals, OR time is a valuable resource with an associated staffing cost that increases through inefficient use (unplanned delays between surgeries, overbooking, performing elective surgeries after hours).…”

“…[1][2][3] Accurate predictions of procedure durations improves OR scheduling and reduces overtime costs, equipment turnover, and wait times for surgeons and patients while increasing surgery throughput and revenues. 1,2,4,5 Although OR scheduling occurs on a smaller scale in veterinary hospitals, OR time is a valuable resource with an associated staffing cost that increases through inefficient use (unplanned delays between surgeries, overbooking, performing elective surgeries after hours). Estimating the duration of procedure (including anesthesia and surgery) requires consideration of surgeon-(experience, training, work rate), procedure-(type, complexity, required equipment) and patient-related (comorbidities, temperament) factors.…”

An Audit of Operating Room Time Utilization in a Teaching Hospital: Is There a Place for Improvement?

“…Moreover, teaching or patient case mix might also influence the induction time [18], as does the individual anaesthetist's performance level. Even for experienced anaesthetists, it is often difficult to predict the duration of anaesthesia induction for a specific case [19]. We should underline the fact that the time needed for induction to anesthesia was proportionally longer for simple compared to less simple procedures, which might be attributed to the involvement of younger, less experienced trainees in simple cases versus more skillful trainees for major surgery.…”

Analisis Anesthesia Ready Time Dalam Pelayanan Anestesi untuk Pembedahan Darurat di Kamar Operasi IGD RSUD Dr. Soetomo Surabaya Tahun 2018

“…mengutarakan bahwa kehadiran konsultan anestesi di penelitiannya adalah 75% dari total sampel. 8,10 KESIMPULAN ART di kamar operasi darurat IGD RSUD Dr. Soetomo sudah mendekati benchmark internasional. Faktor yang mempengaruhi panjangnya ART di kamar operasi darurat IGD RSUD Dr. Soetomo adalah menunggu kedatangan operator (42,5% sampel), pemasangan prosedur invasif anestesi (7,3 % sampel), dan menunggu kedatangan PPDS anestesi yang lebih senior untuk mendampingi proses induksi anestesi (5,2 % sampel).…”