Hanlon John G, Hayter Megan A, Bould M Dylan, Joo Hwan S, Naik Viren N
Department of Anesthesia, St Michael's Anesthesia Research into Teaching (SMART), St Michael's Hospital, University of Toronto, 30 Bond Street, Toronto, ON, Canada M5B 1W8.
Can J Anaesth. 2009 Jan;56(1):27-34. doi: 10.1007/s12630-008-9003-8. Epub 2008 Dec 17.
To compare the self-perceived sleepiness of Canadian anesthesia residents providing modified on-call duties (12-16 h) vs. traditional on-call duties (24 h).
A 25-item online survey was distributed to all Canadian anesthesia residents who, at that time, were on anesthesia rotations. The survey assessed resident demographics, perceived work patterns, and sleepiness, as well as their opinions on resident work hour reform. Self-perceived sleepiness was quantified using the validated Epworth sleepiness scale (ESS).
Three hundred eight of 400 (77%) eligible Canadian anesthesia residents completed the survey. Forty-three percent of residents who worked traditional on-call (duration 24.1 +/- 0.5 h) shifts and 48% of residents who worked modified on-call (duration 15.5 +/- 1.8 h) shifts met ESS criteria for excessive daytime sleepiness. Overall mean ESS scores did not differ significantly between the traditional (9.1 +/- 4.9) and the modified call groups (9.5 +/- 4.8). Residents with an on-call frequency of >or=1:4 days or those who slept <or=2 h while on call perceived themselves as significantly more sleepy (P = 0.045 and P = 0.008, respectively). Six percent of residents admitted to taking "something other than caffeine" to stay awake on call.
Many anesthesia residents do exhibit excessive daytime sleepiness, with a similar incidence for those working within either modified or traditional call systems. Our study suggests that sleepiness may be reduced by scheduling on-call duties no more frequently than one in every five nights and by ensuring that residents sleep more than 2 h while on call.
比较承担改良值班职责(12 - 16小时)与传统值班职责(24小时)的加拿大麻醉住院医师的自我感知困倦程度。
向当时正在进行麻醉轮转的所有加拿大麻醉住院医师发放一份包含25个条目的在线调查问卷。该调查评估住院医师的人口统计学特征、感知的工作模式、困倦程度,以及他们对住院医师工作时间改革的看法。使用经过验证的爱泼华嗜睡量表(ESS)对自我感知困倦程度进行量化。
400名符合条件的加拿大麻醉住院医师中有308名(77%)完成了调查。值传统值班(时长24.1±0.5小时)班的住院医师中有43%,值改良值班(时长15.5±1.8小时)班的住院医师中有48%符合ESS关于白天过度嗜睡的标准。传统值班组(9.1±4.9)和改良值班组(9.5±4.8)的总体平均ESS评分无显著差异。值班频率≥1:4天的住院医师或值班时睡眠时间≤2小时的住院医师自我感觉困倦程度明显更高(分别为P = 0.045和P = 0.008)。6%的住院医师承认在值班时服用了“除咖啡因以外的东西”来保持清醒。
许多麻醉住院医师确实表现出白天过度嗜睡,在改良或传统值班系统下工作的住院医师中这一发生率相似。我们的研究表明,通过将值班安排得频率不超过每五晚一次,并确保住院医师在值班时睡眠时间超过2小时,可能会降低困倦程度。