School of Information Technology and Electrical Engineering, The University of Queensland, Brisbane, Australia.
Anesth Analg. 2010 Apr 1;110(4):1032-8. doi: 10.1213/ANE.0b013e3181d3e647.
Patient monitors in the operating room are often positioned where it is difficult for the anesthesiologist to see them when performing procedures. Head-mounted displays (HMDs) can help anesthesiologists by superimposing a display of the patient's vital signs over the anesthesiologist's field of view. Simulator studies indicate that by using an HMD, anesthesiologists can spend more time looking at the patient and less at the monitors. We performed a clinical evaluation testing whether this finding would apply in practice.
Six attending anesthesiologists provided anesthesia to patients undergoing rigid cystoscopy. Each anesthesiologist performed 6 cases alternating between standard monitoring using a Philips IntelliVue MP70 and standard monitoring plus a Microvision Nomad ND2000 HMD. The HMD interfaced wirelessly with the MP70 monitor and displayed waveform and numerical vital signs data. Video was recorded during all cases and analyzed to determine the percentage of time, frequency, and duration of looks at the anesthesia workstation and at the patient and surgical field during various anesthetic phases. Differences between the display conditions were tested for significance using repeated-measures analysis of variance.
Video data were collected from 36 cases that ranged from 17 to 75 minutes in duration (median 31 minutes). When participants were using the HMD, compared with standard monitoring, they spent less time looking toward the anesthesia workstation (21.0% vs 25.3%, P = 0.003) and more time looking toward the patient and surgical field (55.9% vs 51.5%, P = 0.014). The HMD had no effect on either the frequency of looks or the average duration of looks toward the patient and surgical field or toward the anesthesia workstation.
An HMD of patient vital signs reduces anesthesiologists' surveillance of the anesthesia workstation and allows them to spend more time monitoring their patient and surgical field during normal anesthesia. More research is needed to determine whether the behavioral changes can lead to improved anesthesiologist performance in the operating room.
手术室中的患者监护仪通常放置在麻醉师进行手术时难以看到的位置。头戴式显示器 (HMD) 可以通过将患者生命体征的显示叠加在麻醉师的视野上来帮助麻醉师。模拟器研究表明，使用 HMD，麻醉师可以花更多时间观察患者，而减少看监视器的时间。我们进行了一项临床评估，以检验这一发现是否适用于实际情况。
六名主治麻醉师为接受硬性膀胱镜检查的患者提供麻醉。每位麻醉师在使用 Philips IntelliVue MP70 进行标准监测和使用 Microvision Nomad ND2000 HMD 进行标准监测加 HMD 的情况下各进行 6 例。HMD 通过无线接口与 MP70 监护仪连接，并显示波形和数字生命体征数据。在所有病例中都记录了视频，并进行了分析，以确定在各种麻醉阶段观看麻醉工作站、患者和手术区域的时间百分比、频率和持续时间。使用重复测量方差分析检验显示条件之间的差异是否具有统计学意义。
从持续时间为 17 至 75 分钟（中位数 31 分钟）的 36 例病例中收集了视频数据。当参与者使用 HMD 时，与标准监测相比，他们看向麻醉工作站的时间减少（21.0%比 25.3%，P = 0.003），看向患者和手术区域的时间增加（55.9%比 51.5%，P = 0.014）。HMD 对看向患者和手术区域或麻醉工作站的频率或平均持续时间均无影响。
HMD 显示患者生命体征可减少麻醉师对麻醉工作站的监视，并使他们在进行正常麻醉时能够更多地监测患者和手术区域。需要进一步研究以确定行为变化是否可以提高麻醉师在手术室中的表现。
