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Anaesthesia workload measurement devices: qualitative systematic review
  1. Dalal S Almghairbi,
  2. Takawira C Marufu,
  3. Iain K Moppett
  1. Anaesthesia and Critical Care Research Group, Division of Clinical Neuroscience, Queen’s Medical Centre, University of Nottingham, Nottingham, UK
  1. Correspondence to Dalal S Almghairbi, Anaesthesia and Critical Care Research Group, Division of Clinical Neuroscience, Queen’s Medical Centre, University of Nottingham, Nottingham NG7 2UH, UK; msxda{at}


Background Management of mental workload is a key aspect of safety in anaesthesia but there is no gold-standard tool to assess mental workload, risking confusion in clinical and research use of such tools.

Objective This review assessed currently used mental workload assessment tools.

Methods A systematic literature search was performed on the following electronic databases; Cochrane, EMBASE, MEDLINE, SCOPUS and Web of Science. Screening and data extraction were performed individually by two authors. We included primary published papers focusing on mental workload assessment tools in anaesthesia.

Results A total of 2331 studies were screened by title, 32 by full text and 24 studies met the inclusion criteria. Six mental workload measurement tools were observed across included studies. Reliability for the Borg rating scales and Vibrotactile device was reported in two individual studies. The rest of the studies did not record reliability of the tool measurements used. Borg rating scales, NASA-TLX and task-oriented mental work load measurements are subjective, easily available, readily accessible and takes a few minutes to complete. However, the vibrotactile and eye-tracking methods are objective, require more technical involvement, considerable time for the investigator and moderately expensive, impacting their potential use.

Conclusion We found that the measurement of mental workload in anaesthesia is an emerging field supporting patient and anaesthetist safety. The self-reported measures have the best evidence base.

  • workload
  • over load
  • anaesthesia
  • anaesthetist
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  • Contributors DSA and IKM made substantial contributions to conception and design of the study. DSA and TCM created search strategies and data extraction. DSA participated in drafting the article and IKM in revising it critically for important intellectual content. IKM gave final approval of the version to be submitted.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests This work forms part of DA’s PhD thesis, which is supported by scholarship from the Libyan Ministry of Higher Education and university of Zawia. TCM was a PhD student supported by a grant from the Sir Jules Thorn Charitable Trust. IKM is a member of the NICE topic expert group for Quality Standards for hip fracture, Deputy Director of the National Institute of Academic Anaesthesia (NIAA) Research Council and holds grants from the National Institute for Health Research and the Association of Anaesthetists of Great Britain & Ireland and Royal College of Anaesthetists through the NIAA for trials in hip fracture.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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