(S-228) Reich, D.L., Monday 9:15

TITLE: MANUAL ANESTHESIA RECORDS DO NOT ACCURATELY REFLECT BLOOD PRESSURE AND HEART RATE

AUTHORS: David L. Reich, MD, Richard K. Wood, BS, Raafat Mattar, MD, Marina Krol, PhD, David Adams, MD, Carol A. Bodian, DrPH
AFFILIATION: Mount Sinai School of Medicine, New York, NY.

BACKGROUND: Previous literature suggests that manual anesthesia records are inaccurate in comparison with computer- generated anesthesia records, but these studies are limited by small sample sizes, unblinded study design, and unpaired statistical comparisons.
METHODS: 81 pairs of manual and computer-generated neurosurgical anesthesia records were retrospectively compared using a case-control design. Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), and heart rate (HR) data were transcribed from manual records every 5 minutes. In computer records, the median of up to 20 values was calculated for SAP, DAP, and HR for every 5 minute epoch. The peak, trough, standard deviation, median, and the absolute value of the fractional rate of change (|FCM|) between adjacent 5-minute epochs were calculated for each case. Wilcoxon tests were used for analysis.
RESULTS: For SAP, the manual record peak, standard devia- tion, and |FCM| were less than, and the trough and median were greater than computer records (all p<0.05). For DAP, the manual record peak, standard deviation, and |FCM| were less than, and the trough was greater than computer records (all p<0.05). For HR, the manual record standard deviation and |FCM| were less than, and the trough and median were greater than computer records (all p<0.05). Comparing pooled data for all cases, the prevalence of abnormal values in computer records was markedly greater.
CONCLUSIONS: The inaccuracy of manual anesthesia records must be considered when they are used as source material for research, quality assurance, and medico-legal purposes.

Table. Pairwise Comparisons (median [range])

* P<0.05.