Is Procedural Anesthesia Safety Similar Between Residents and Attending Surgeons?

Area of Science:

• Oral and Maxillofacial Surgery
• Anesthesia
• Patient Safety

Background:

• The safety of single-provider anesthesia in oral and maxillofacial surgery (OMS) is established.
• Previous studies show similar operative outcomes between attending surgeons and residents.
• The safety of procedural anesthesia (deep sedation to general) administered by residents versus attendings in OMS is less clear.

Purpose of the Study:

• To compare the frequencies of anesthesia-related adverse events between OMS residents and attending surgeons.
• To evaluate the safety of procedural sedation administered by trainees versus experienced clinicians.

Main Methods:

• Retrospective cohort study of 3,940 patients receiving procedural sedation between 2012 and 2020.
• Data extracted from electronic medical records and paper charts at an academic outpatient clinic.
• Adverse events (respiratory, cardiac, neurological, allergy, aspiration, medication errors) were compared between sedation administered by residents and attendings.

Main Results:

• A total of 3,940 patients were included; 25.1% received sedation from residents and 74.9% from attendings.
• One adverse event (0.1%) occurred in the resident group (apnea).
• Two adverse events (0.07%) occurred in the attending group (bradycardia, postoperative nausea/vomiting); no statistically significant difference (P=1.0).

Conclusions:

• Procedural sedation by OMS residents and attendings demonstrated a similarly low rate of adverse events (0.08%) with no permanent sequelae.
• Findings support the safety of supervised resident-administered sedation in OMS.
• Current OMS training protocols for procedural sedation are validated by these results.