S. Aguirre1,3, A. Brown1, J.A. Broski1, D. Hughes2, T.G. Hughes2, E. Plaza1, L.V. Selby1 1University of Kansas Medical Center, Surgery, Kansas City, KANSAS, USA 2University of Kansas Medical Center, Surgery, Salina, KANSAS, USA 3University of Kansas School of Medicine, Kansas City, KANSAS, USA
Introduction:
Surgeon-anesthesiologist collaboration is essential for the safe performance of surgery, yet the nuances of this collaboration are poorly understood. We hypothesized surgeons would be comfortable discussing procedure-specific considerations but would be less comfortable discussing overall anesthetic approach. We also hypothesized that surgeons would be unfamiliar with, and uncomfortable discussing, the use if inhaled (IA) or total intravenous anesthesia (TIVA), which has been associated with improved post-operative recovery and improved post-operative oncologic outcomes including associations with lower rates of cancer recurrence and higher overall survival.
Methods:
Following IRB approval, we surveyed members of the American College of Surgeons ACS Communities platform. Surgeons self-reported their comfort and familiarity (1: Not at all comfortable/familiar – 5: Very comfortable/familiar) discussing specific anesthetic considerations and self-assessed their knowledge of general anesthesia approaches (Table 1). Informed consent was obtained from all participants. Summary statistics were compared between anesthetic topics.
Results:
In total, 150 attending surgeons completed the survey. For procedure-specific considerations (epidural placement, peripheral nerve blocks, central venous access, resuscitation) comfort will collaboration was very high (Table 1). Surgeons were less familiar with, and less comfortable discussing, the differences between IA and TIVA, and whether patient should receive TIVA (Mean:3.58; Median:4).
Conclusion:
Overall, surgeons are very comfortable collaborating with anesthesiologists on focused, procedure-specific anesthetic decisions. However, they are less familiar with, and less comfortable discussing, differing approaches to delivering general anesthesia. Improved patient outcomes associated with TIVA adoption likely remain out of reach until surgeon comfort discussing this topic increases.