This project is a collaboration between The University of Texas at San Antonio and the University of Florida. I am the developer of the anesthesia simulator tool. Below is a video overview of this project, but it is an relatively old version. For more current version, please go to projects page and download.
And the research we conducted with my tool:
AIM: We studied whether anesthesia providers account for racial differences in propofol sensitivity (reported in the anesthesia literature) when selecting loading doses for propofol sedation and analgesia.
METHODS: We developed a mixed reality simulator consisting of a 3D virtual human and a physical mannequin. Based on published data, propofol pharmacodynamics was altered, in order of increasing sensitivity (loss of consciousness, LOC, determined by loss of response to verbal commands at lower effect site concentrations), for Caucasian, Black and Indian (South Asian) patients. With IRB approval and informed consent, anesthesia providers administered propofol sedation and analgesia for upper GI endoscopy to three consecutive simulated male patients (Caucasian, Indian, Black) that were otherwise similar. Users interacted with the mannequin (verbal, jaw thrusts, shaking); the virtual representation depicted movement and pain response and a different patient appearance based on race.
RESULTS: There were 37 study participants (23 males, 14 females; 13 faculty members, 10 residents, 8 nurse anesthetists, 3 fellows, 3 anesthesiology assistants; age: 28-68, 38.6±10.1 years; experience delivering propofol during sedation and analgesia: 1-20, 6.8±5.8 years. The loading doses were Caucasian (0.27-1.71, 0.77±0.31 mg/kg), Indian (0.29–1.71, 0.80±0.32 mg/kg), Black (0.25-1.71 0.79±0.28 mg/kg). The time durations of oversedation (LOC) were Caucasian (0-318, 147±85 s), Indian (26–338, 207±68 s), Black (0-367, 191±81 s). Between patient races, there was no significant difference in loading doses (p=???) and a significant difference in LOC duration (p=???).
CONCLUSIONS: If the above data collected in a simulated environment at an academic health center in the Southeast United States are representative of actual clinical practice, it indicates a race-blind formulaic pproach that predisposes sensitive races to oversedation and a learning gap that may need to be addressed in training programs.
