Brazilian Journal of Anesthesiology
https://bjan-sba.org/article/doi/10.1590/S0034-70942004000500012
Brazilian Journal of Anesthesiology
Miscellaneous

O plantão noturno em anestesia reduz a latência ao sono

Short sleep latency in residents after a period on duty in anesthesia

Lígia Andrade da Silva Telles Mathias; Christina Morotomi Funatsu Coelho; Elizabeth Pricoli Vilela; Joaquim Edson Vieira; Marcelo Lacava Pagnocca

http://dx.doi.org/10.1590/S0034-70942004000500012 Braz J Anesthesiol, vol.54, n5, p.693-699, 2004
PDF Português
PDF English
Downloads: 1
Views: 1128

Resumo

JUSTIFICATIVA E OBJETIVOS: Os médicos em geral, os anestesiologistas em particular, têm jornadas de trabalho prolongadas. Os residentes de Anestesiologia podem apresentar fadiga e estresse significativos. O objetivo deste trabalho foi verificar, em residentes de primeiro e segundo anos a latência do sono em períodos após plantão. MÉTODO: Foram avaliados 11 residentes em situações distintas: às 7 horas da manhã, após noite de sono normal (> 7h), sem plantão nos 3 dias anteriores (M1); às 7 horas da manhã, após 24 horas de trabalho, sem dormir, sem plantão nos 3 dias anteriores (M2); às 13 horas da tarde, após 30 horas de trabalho, sem dormir, sem plantão nos 3 dias anteriores (M3). Em todas essas situações foi realizado eletroencefalograma (EEG) contínuo, em sala apropriada para registro dos sinais de sono, avaliando a latência ao sono (LS). RESULTADOS: Verificou-se redução significativa da LS entre os residentes, após 24 ou 30 horas de plantão sem dormir. Entre os residentes que tiveram noite de sono normal na véspera do exame, 36,4% apresentaram LS em nível considerado patológico. CONCLUSÕES: A jornada de plantão de 24 ou 30 horas leva a valores de LS menores que 5 minutos, considerados patológicos, refletindo a fadiga extrema de residentes de Anestesiologia. Pode ser importante a regulamentação do número de horas de descanso pós-plantão.

Palavras-chave

ANESTESIOLOGISTA, SISTEMA NERVOSO CENTRAL

Abstract

BACKGROUND AND OBJECTIVES: Physicians in general, and anesthesiologists in particular, have long working hours. Residents of Anesthesiology may present significant fatigue and stress. This study aimed at investigating first and second year residents’ sleep latency after a period on duty. METHODS: Participated in this study 11 residents in different situations: at 7:00 am, after a normal night sleep (> 7 h), without on duty period in the last 3 days (M1); at 7:00 am, after 24h of night work, without on duty period in the last 3 days (M2); and at 1:00 pm after 30h of work without on duty period in the last 3 days (M3). Continuous EEG was performed for all situations in adequate room to record sleep signals. Sleep latency (SL) was evaluated. RESULTS: There has been significant shorter SL among residents after 24 or 30 hours without sleep. From residents after a normal night sleep the day before the evaluation, 36.4% presented pathological SL levels. CONCLUSIONS: Periods on duty for 24 or 30 hours lead to SL values below 5 minutes, which are considered pathologic and reflect extreme fatigue of residents of Anesthesiology. It might be important to standardize the number of resting hours after duty periods.

Keywords

ANESTHESIOLOGIST, CENTRAL NERVOUS SYSTEM

References

Kestin IG, Miller BR, Lockhart CH. Auditory alarms during anesthesia monitoring. Anesthesiology. 1988;69:106-109.

Howard SK, Rosekind MR, Katz JD. Fatigue in anesthesia: implications and strategies for patient and provides safety. Anesthesiology. 2002;97:1281-1294.

Howard SK. The anesthesiologist and fatigue. Am Soc Anesth Newsletter. 2001;65:1-4.

Weinger MB, Englund CE. Ergonomic and human factors affecting anesthetic vigilance and monitoring performance in the operating room environment. Anesthesiology. 1990;73:995-1021.

Howard SK, Keshavacharya S, Brian ES. Behavioral evidence of fatigue during a simulator experiment. Anesthesiology. 1996;89:A1236.

Lyznicki JM, Doege TC, Davis RM. Sleepiness, driving, and motor vehicle crashes. JAMA. 1998;279:1908-1913.

Mitler MM, Carskadon MA, Czeisler CA. Catastrophes, sleep, and public policy: consensus report. Sleep. 1988;11:100-109.

Jha AK, Duncan BW, Bates DW. Fatigue - Sleepiness and Medical Errors. Making Health Care Safer: A Critical Analysis of Patient Safety Practices Agency for Healthcare Research and Quality. May ;01-E058.

Lydic R. Fact and fantasy about sleep and Anesthesiology. Anesthesiology. 2002;97:1050-1051.

Daugherty SR, Baldwin Jr DC, Rowley BD. Learning, satisfaction, and mistreatment during medical internship: a national survey of working conditions. JAMA. 1998;279:1194-1199.

Williamson AM, Feyer AM. Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occup Environ Med. 2000;57:649-655.

Parks DK, Yetman RJ, McNeese MC et al. Day-night pattern in accidental exposures to blood-borne pathogens among medical students and residents. Cronobiol Int. 2000;17:61-70.

Marcus CL, Loughlin GM. Effect of sleep deprivation on driving safety in housestaff. Sleep. 1996;19:763-766.

Berry RB. Sleep Medicine Pearls. 1999:1-6.

Rechtschaffen A, Kates A. A Manual of Standardized Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects - Principles and Practice of Sleep Medicine. 2000:93-111.

Keenan RL. Anesthesia disasters: incidence, causes, and preventability. Semin Anesth. 1986;5:175-179.

Olsson GL, Hallen B. Cardiac arrest during anesthesia. A computer-aided study in 250,543 anaesthetics. Acta Anaesthesiol Scand. 1988;32:653-664.

Cooper JB, Newbower RS, Kitz RJ. An analysis of major errors and equipment failures in anesthesia management: considerations for prevention and detection. Anesthesiology. 1984;60:34-42.

Craig J, Wilson ME. A survey of anaesthetic misadventures. Anaesthesia. 1981;36:933-936.

Cooper JB, Newbower RS, Long CD. Preventable anesthesia mishaps: a study of human factors. Anesthesiology. 1978;49:399-406.

Taffinder NJ, McManus IC, Russell RC. Effect of sleep deprivation on surgeons’ dexterity on laparoscopy simulator. Lancet. 1998;352(9135):1191.

Mitler MM, Miller J. Methods of testing for sleepliness. Behav Med. 1996;21:171-183.

Geer RT, Jobes DR, Tew Jr JD. Incidence of automobile accidents involving anesthesia residents after on-call duty cycles. Anesthesiology. 1997;87:A938.

Asch DA, Parker RM. The Libby Zion case. One step forward or two steps backward?. N Engl J Med. 1988;318:771-775.

Mhyre JH. New York limitations give residents a break. Am Soc Anesth Newsletter. 2002;66(31).

5dd6e5680e8825634113f287 rba Articles
Links & Downloads
2352-2291 (Electronic) 0104-0014 (Printed)
Braz J Anesthesiol ©2024 All rights reserved.

Braz J Anesthesiol

Share this page
Page Sections