• Ségolène Arzalier-Daret, Clément Buléon, Marie-Laure Bocca, Pierre Denise, Jean-Louis Gérard, and Jean-Luc Hanouz.
• Pôle de réanimations-anesthésie (niveau 6), CHU de Caen, avenue Côte-de-Nacre, 14033 Caen cedex 9, France; Pôle des formations et de recherche en santé, laboratoire de simulation médicale NorSims, faculté de médecine, UNICAEN, université Caen-Normandie, 2, rue des Rochambelles, 14032 Caen cedex, France. Electronic address: arzalier-s@chu-caen.fr.
• Anaesth Crit Care Pain Med. 2018 Apr 1; 37 (2): 161-166.

BackgroundSleep deprivation has been associated with an increased incidence of medical errors and can jeopardise patients' safety during medical crisis management. The aim of the study was to assess the effect of sleep deprivation on the management of simulated anaesthesia crisis by residents in anaesthesiology.MethodsA randomised, comparative, monocentric crossover study involving 48 residents in anaesthesia was performed on a high fidelity patient simulator. Each resident was evaluated in a sleep-deprived state (deprived group, after a night shift duty) and control state (control group, after a night of sleep). Performance was assessed through points obtained during crisis scenario 1 (oesophageal intubation followed by anaphylactic shock) and scenario 2 (anaesthesia-related bronchospasm followed by ventricular tachycardia). Sleep periods were recorded by actigraphy. Two independent observers assessed the performances. The primary endpoint of the study was the score obtained for each scenario.ResultsResident's crisis management performance is associated with sleep deprivation (scenario 1: control=39 [33-42] points vs. deprived=26 [19-40] points, P=0.02; scenario 2: control=21 [17-24] vs. deprived=14 [12-19], P=0.01). The main errors observed were: error in drug administration and dose, delay in identification of hypotension, and missing communication with the surgical team about situation.ConclusionsThe present study showed that sleep deprivation is associated with impairment of performance to manage crisis situations by residents in anaesthesia.Copyright © 2017 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier Masson SAS. All rights reserved.

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