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PACU Outcomes Across Anesthesiology Resident Training Levels: A Retrospective Cohort Study
Hayden B Jefferies1, Landon C Rosckes1, David A Hundley1
1The authors are at the University of Texas Health Science Center at Houston, Houston, TX. is an assistant professor, is an assistant professor, and is an associate professor in the Department of Anesthesiology, Critical Care and Pain Medicine, and is a medical student in the McGovern Medical School.
Anesthesiology resident training level did not independently impact postoperative recovery outcomes like opioid use or antiemetic administration. Patient and procedural factors, not resident experience, explained variations in postanesthesia care unit (PACU) recovery metrics.
Area of Science:
- Anesthesiology
- Patient Safety
- Medical Education
Background:
- Postoperative recovery metrics such as opioid use, antiemetic administration, and postanesthesia care unit (PACU) stay are critical.
- It remains unclear if anesthesiology resident training level influences these outcomes independently of patient and procedural factors.
- Understanding these patterns is key to differentiating resident experience effects from patient or procedural influences on recovery.
Purpose of the Study:
- To investigate whether postanesthesia care unit (PACU) recovery outcomes vary across different anesthesiology resident training levels.
- To determine if resident experience is an independent predictor of postoperative recovery metrics.
Main Methods:
- A retrospective cohort study analyzed 7699 adult nonobstetric anesthetics.
- Data were stratified by resident training level (first-, second-, or third-year).
- Primary outcome was PACU morphine milligram equivalents; secondary outcomes included rescue antiemetic use and recovery time, analyzed using multivariable regression adjusted for covariates.
Main Results:
- Significant variations in patient and case characteristics were observed across resident levels.
- After multivariable adjustment, resident training level showed no independent association with PACU opioid use, rescue antiemetic administration, or recovery time.
- Unadjusted differences in recovery measures were attributable to patient and procedural factors.
Conclusions:
- Resident training level is not an independent predictor of key postanesthesia care unit (PACU) recovery outcomes.
- Observed variations in opioid use, antiemetic administration, and recovery time are explained by patient and procedural factors.
- This underscores the importance of case-mix adjustment in educational settings and highlights the complex interplay of factors influencing postanesthesia recovery.
