Manual record keeping is not necessary for anesthesia vigilance.

OBJECTIVE

The goal of this study was to determine whether the intraoperative vigilance of anesthesia residents is different when they keep a manual record than when an assistant performs the charting.

METHODS

A total of 9 anesthesia residents were studied during 36 general anesthesia cases on ASA class 1 or 2 patients. In half of the cases, the resident performed all record keeping. In the other half, the anesthesia record was kept by a human assistant. Vigilance was measured as detection rate and response time for the resident to detect a simulated abnormal value displayed on the physiologic monitor. For analysis, anesthesia cases were divided into stages of induction, maintenance, and emergence.

RESULTS

Response times and detection rates were not different when record keeping was performed by an assistant, rather than by the clinician. Shorter cases were associated with longer median response times (i.e., lower vigilance) during the maintenance phase, but only when record keeping was done manually.

CONCLUSIONS

The results demonstrate that anesthesia residents are equally attentive to an experimental signal displayed on an electronic monitor while manually charting as they are when an assistant keeps the record. This brings into question the contention that eliminating the record-keeping task will result in a reduced level of vigilance.