Laura Münst1, Martin Schläpfer2, Peter Biro3. 1. Department of Internal Medicine, Spital Zollikerberg, Zollikerberg, Switzerland. 2. Institute of Physiology and Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland. 3. Institute of Anesthesiology, University Hospital Zurich, Zurich, Switzerland.
Abstract
OBJECTIVE: Various drugs are available for general anaesthesia, and the anaesthesiologist in charge may choose the one that is considered as the most appropriate for each specific case. When selecting an anaesthetic drug, its specific pharmacokinetic and pharmacodynamics as well as certain non-pharmacological properties have to be considered. This may lead to decisions that may be justified or unjustified according to scientific evidence and local standards. METHODS: In a prospective, single-centre, non-randomised and non-interventional study, 30 attending anaesthetists were interviewed about their drug prescription for general anaesthesia cases scheduled for the next day. The stated reasons for their choices from available alternatives were recorded and analysed for being justified or unjustified. RESULTS: We found 69% of all decisions as justified, while 31% were incorrect, unjustified or random. Female anaesthetists made 83%±15% justified decisions, whereas males achieved a lower performance with 69%±17% justified decisions (p=0.046). CONCLUSION: To a large proportion, convenience, habit and personal preferences influence the decision-making in choosing the anaesthetic medication. A change of paradigm in the postgraduate education and training seems to be necessary.
OBJECTIVE: Various drugs are available for general anaesthesia, and the anaesthesiologist in charge may choose the one that is considered as the most appropriate for each specific case. When selecting an anaesthetic drug, its specific pharmacokinetic and pharmacodynamics as well as certain non-pharmacological properties have to be considered. This may lead to decisions that may be justified or unjustified according to scientific evidence and local standards. METHODS: In a prospective, single-centre, non-randomised and non-interventional study, 30 attending anaesthetists were interviewed about their drug prescription for general anaesthesia cases scheduled for the next day. The stated reasons for their choices from available alternatives were recorded and analysed for being justified or unjustified. RESULTS: We found 69% of all decisions as justified, while 31% were incorrect, unjustified or random. Female anaesthetists made 83%±15% justified decisions, whereas males achieved a lower performance with 69%±17% justified decisions (p=0.046). CONCLUSION: To a large proportion, convenience, habit and personal preferences influence the decision-making in choosing the anaesthetic medication. A change of paradigm in the postgraduate education and training seems to be necessary.
Entities:
Keywords:
Anaesthetic drugs; decision making; postgraduate education; practice standards