A retrospective analysis of factors associated with anesthetic case duration for cesarean deliveries

Int J Obstet Anesth. 2018 May;34:42-49. doi: 10.1016/j.ijoa.2018.01.002. Epub 2018 Jan 13.


Introduction: Accurately predicting cesarean delivery case duration is an integral component of designing appropriate workflow protocols and ensuring adequate provider availability. Our primary objective was to describe the variability of case duration, based on factors that we hypothesized would be influential, such as hospital facility type, United States region, time of day, case volume, and patient and provider characteristics.

Methods: We analyzed hospital-, patient-, and provider-level variables from the National Anesthesia Clinical Outcomes Registry, a voluntary registry created to share anesthesia-related data and outcomes. Multivariable linear regression was performed to assess the association of these variables to case duration.

Results: A total of 205332 cases were included in the final analysis. The majority of these cases came from medium-sized community hospitals (50.8%). Mean and median case duration were 115 and 79 minutes, respectively. Mean duration was longest for cases performed at university hospitals (143 min, standard deviation 136 min). Case duration varied in clinically meaningful ways based on hospital facility type, United States region, presence of a Certified Registered Nurse Anesthetist, and anesthesia type. Differences were not clinically significant with respect to other variables studied.

Conclusion: This study analyzed national cesarean delivery data and determined factors associated with cesarean delivery duration. We showed that case durations varied in meaningful ways according to facility type, United States region, presence of a Certified Registered Nurse Anesthetist, and anesthesia type. Our work contributes to a small but growing body of research on optimal staffing models for anesthesia practices.

Keywords: Anesthesia; Case; Cesarean delivery; Duration; Efficiency.

MeSH terms

  • Adult
  • Age Factors
  • Anesthesia, Conduction
  • Anesthesia, General / statistics & numerical data
  • Anesthesia, Obstetrical / statistics & numerical data*
  • Anesthesiologists / statistics & numerical data
  • Cesarean Section / statistics & numerical data*
  • Factor Analysis, Statistical
  • Female
  • Hospitals / statistics & numerical data
  • Hospitals, University / statistics & numerical data
  • Humans
  • Nurse Anesthetists / statistics & numerical data
  • Operative Time*
  • Pregnancy
  • Registries
  • Retrospective Studies
  • United States