Key result
Only 9.1% of surveyed Chinese anaesthesiologists routinely use depth of anaesthesia monitors, with academic respondents primarily using them to prevent awareness and nonacademic respondents to guide anaesthetic delivery.
Why the study?
The study aimed to explore whether Chinese anaesthesiologists mainly use depth of anaesthesia monitors to prevent intraoperative awareness and whether accuracy is the most crucial performance factor.
Cross-Sectional (n=4,037)
Yes
Routine use of depth of anesthesia monitors among Chinese anesthesiologists is low (9.1%), with a strong demand for improved accuracy and integration of artificial intelligence.
Low adoption signals gaps in anaesthetic monitoring practices in China; leaves open barriers, outcomes, and AI integration needs.
Background In this study, we aimed to analyse survey data to explore two different hypotheses; and for this purpose, we distributed an online survey to Chinese anaesthesiologists. The hypothetical questions in this survey include: (1) Chinese anaesthesiologists mainly use the depth of anaesthesia (DoA) monitors to prevent intraoperative awareness and (2) the accuracy of these monitors is the most crucial performance factor during the clinical daily practice of Chinese anaesthesiologists. Methods We collected and statistically analysed the response of a total of 12,750 anesthesiologists who were invited to participate in an anonymous online survey. The Chinese Society of Anaesthesiologists (CSA) trial group provided the email address of each anaesthesiologist, and the selection of respondents was random from the computerized system. Results The overall response rate was 32.0% (4037 respondents). Only 9.1% (95% confidence interval, 8.2-10.0%) of the respondents routinely used DoA monitors. Academic respondents (91.5, 90.3-92.7%) most frequently used DoA monitoring to prevent awareness, whereas nonacademic respondents (88.8, 87.4-90.2%) most frequently used DoA monitoring to guide the delivery of anaesthetic agents. In total, the number of respondents who did not use a DoA monitor and whose patients experienced awareness (61.7, 57.8-65.6%) was significantly greater than those who used one or several DoA monitors (51.5, 49.8-53.2%). Overall, the crucial performance factor during DoA monitoring was considered by 61.9% (60.4-63.4%) of the respondents to be accuracy. However, most respondents (95.7, 95.1-96.3%) demanded improvements in the accuracy of the monitors for DoA monitoring. In addition, broad application in patients of all ages (86.3, 85.2-87.4%), analgesia monitoring (80.4, 79.2-81.6%), and all types of anaesthetic agents (75.6, 74.3-76.9%) was reported. In total, 65.0% (63.6-66.5%) of the respondents believed that DoA monitors should be combined with EEG and vital sign monitoring, and 53.7% (52.1-55.2%) believed that advanced DoA monitors should include artificial intelligence. Conclusions Academic anaesthesiologists primarily use DoA monitoring to prevent awareness, whereas nonacademic anaesthesiologists use DoA monitoring to guide the delivery of anaesthetics. Anaesthesiologists demand high-accuracy DoA monitors incorporating EEG signals, multiple vital signs, and antinociceptive indicators. DoA monitors with artificial intelligence may represent a new direction for future research on DoA monitoring.
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Zhan et al. (2021) conducted a cross-sectional in Anaesthesiologists' practices and attitudes regarding depth of anaesthesia monitoring (n=4,037). Depth of anaesthesia (DoA) monitoring was evaluated on Routine use of DoA monitors (95% CI 8.2-10.0). Only 9.1% of surveyed Chinese anaesthesiologists routinely use depth of anaesthesia monitors, with academic respondents primarily using them to prevent awareness and nonacademic respondents to guide anaesthetic delivery.
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