Impact of anesthesiologist experience on neuraxial anesthesia outcomes in cesarean sections

BACKGROUND: Despite the requirement for meticulous management of cesarean anesthesia, no study has explored the impact of novice trainee anesthesiologists in this field. This study assessed challenges in neuraxial anesthesia for cesarean sections and compared outcomes between novice and senior anesthesiologists. METHODS: We retrospectively analyzed 446 cesarean sections with neuraxial anesthesia. The primary objective was to evaluate the impact of anesthesiologists' experience on the time required to administer neuraxial anesthesia and whether maternal body mass index (BMI) influenced this relationship. Secondary objectives included examining maternal hemodynamic variability, operative details, and newborn outcomes relative to the anesthesiologist's experience. RESULTS: Novice anesthesiologists required a significantly longer time to perform neuraxial anesthesia (24.9 [7.1] min vs. 18.2 [7.0] min, P<0.001) than their senior counterparts. A significant interaction was observed between anesthesiologist experience and maternal BMI on the time to administer neuraxial anesthesia (P=0.017), with a moderate correlation between BMI and administration time for novices (r=0.50, P<0.001) and only a slight correlation for seniors (r=0.17, P=0.001). Experience level did not significantly affect intraoperative hemodynamics, Apgar scores, or umbilical cord blood gas analyses. CONCLUSIONS: The effect of maternal BMI on the difficulty of performing neuraxial anesthesia in parturients can be more pronounced for novice anesthesiologists than for experienced ones. Despite requiring more time to perform neuraxial anesthesia, novice anesthesiologists do not significantly affect maternal hemodynamics or newborn distress during obstetric anesthesia, provided that they are under the supervision of experienced anesthesiologists.