Hughes Lauren, Murphy Orla, Lenihan Martin, Mhuircheartaigh Róisín Ní, Wall Thomas P
Department of Anaesthesia, Mater Misericordiae University Hospital, Dublin, Ireland.
University College Dublin, Dublin, Ireland.
BJA Open. 2023 Mar;5:100117. doi: 10.1016/j.bjao.2022.100117. Epub 2022 Dec 5.
The COVID-19 pandemic disrupted healthcare services worldwide, with a consequent impact on the delivery of medical education and training in all acute care specialties. Anaesthesia training has been challenged by a combination of reduced elective theatre activity, redeployment of trainees to critical care units, and changes in standard anaesthetic practices.
The aim of this study was to quantify the impact of COVID-19 on specialist anaesthesia training at a tertiary level teaching hospital in Ireland via a retrospective analysis of data captured by electronic anaesthesia records. The anaesthetic caseloads of trainees in periods before and during the pandemic were analysed along with airway management practices, core procedural skills performed, and critical care rostering. Data relating to 145 anaesthesia trainees were captured during the study periods: pre-pandemic (January 2018 to January 2020) and pandemic (January 2020 to January 2022).
The mean number of theatre cases logged per trainee in a 6-month period reduced from 156.8 pre-pandemic to 119.2 during the pandemic (23.9% reduction; <0.0001). Although theatre caseload was reduced, trainees gained additional critical care experience with a significant increase in overall days spent staffing critical care wards. In the theatre setting, the number of arterial lines, central lines, neuraxial blocks, and peripheral nerve blocks performed were significantly reduced during the pandemic.
Although the COVID-19 pandemic significantly reduced anaesthesia training exposure and increased critical care exposure over an extended period, the overall long-term significance of this alteration in the anaesthesia training experience remains uncertain.
新冠疫情扰乱了全球医疗服务，进而影响了所有急症护理专业的医学教育与培训。麻醉培训面临着多种挑战，包括择期手术活动减少、学员被重新部署到重症监护病房以及标准麻醉操作的改变。
本研究旨在通过对电子麻醉记录所捕获的数据进行回顾性分析，量化新冠疫情对爱尔兰一家三级教学医院专科麻醉培训的影响。分析了疫情前和疫情期间学员的麻醉病例数量，以及气道管理实践、所执行的核心操作技能和重症监护排班情况。在研究期间收集了145名麻醉学员的数据：疫情前（2018年1月至2020年1月）和疫情期间（2020年1月至2022年1月）。
每位学员在6个月期间记录的平均手术病例数从疫情前的156.8例降至疫情期间的119.2例（减少23.9%；<0.0001）。尽管手术病例数量减少，但学员获得了额外的重症监护经验，在重症监护病房值班的总天数显著增加。在手术室环境中，疫情期间动脉穿刺置管、中心静脉置管、神经阻滞和外周神经阻滞的操作数量显著减少。
尽管新冠疫情在较长时期内显著减少了麻醉培训机会并增加了重症监护接触机会，但麻醉培训经历的这种改变的总体长期意义仍不确定。
