title: [Anesthesia management by residents does not alter the incidence of recall of tracheal extubation: a teaching hospital-based propensity score analysis].
abstract: OBJECTIVE
  The memory of emergence from anesthesia is recognized as one type of anesthesia awareness. Apart from planed awake extubation, unintentional recall of tracheal extubation is thought to be the results of inadequate anesthesia management; therefore, the incidence can be related with the experience of anesthetists. To assess whether the incidence of recall of tracheal extubation is related to anesthetists' experience, we compared the incidence of recall of tracheal extubation between patients managed by anesthesia residents or by experienced anesthetists.
  
  
  METHODS
  This is a retrospective review of an institutional registry containing 21,606 general anesthesia cases and was conducted with the board of ethical review approval. All resident tracheal extubations were performed under anesthetists' supervision. To avoid channeling bias, propensity score analysis was used to generate a set of matched cases (resident managements) and controls (anesthetist managements), yielding 3,475 matched patient pairs. The incidence of recall of tracheal extubation was compared as primary outcomes.
  
  
  RESULTS
  In the unmatched population, there was no difference in the incidences of recall of tracheal extubation between resident management and anesthetist management (6.5% vs. 7.1%, p=0.275). After propensity score matching, there was still no difference in incidences of recall of tracheal extubation (7.1% vs. 7.0%, p=0.853).
  
  
  CONCLUSIONS
  In conclusion, when supervised by an anesthetist, resident extubations are no more likely to result in recall than anesthetist extubations.
authors.affiliation: Nara Medical University, Department of Anesthesiology and Division of Intensive Care, Shijo-cho Kashihara, Nara, Japão. Electronic address: seninoue@naramed-u.ac.jp.
authors.forename: Satoki
authors.initials: S
authors.lastname: Inoue
authors.affiliation: Nara Medical University, Department of Anesthesiology and Division of Intensive Care, Shijo-cho Kashihara, Nara, Japão.
authors.forename: Ryuichi
authors.initials: R
authors.lastname: Abe
authors.affiliation: Nara Medical University, Department of Anesthesiology and Division of Intensive Care, Shijo-cho Kashihara, Nara, Japão.
authors.forename: Yuu
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Nara Medical University, Department of Anesthesiology and Division of Intensive Care, Shijo-cho Kashihara, Nara, Japão.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kawaguchi
mesh_terms: D060666:Airway Extubation / Q000523:psychology; D000768:Anesthesia, General; D000776:Anesthesiology / Q000193:education; D005260:Female; D006784:Hospitals, Teaching; D006801:Humans; D015994:Incidence; D007396:Internship and Residency; D058926:Intraoperative Awareness / Q000453:epidemiology* / Q000523:psychology; D008297:Male; D011939:Mental Recall; D008875:Middle Aged; D057216:Propensity Score; D012189:Retrospective Studies
keywords: Academic Medical Centers; Airway extubation; Awareness; Centros Médicos Acadêmicos; Consciência; Extubação