Anaesthesia under the influence : understanding cognitive biases to combat them more effectively
Seance of wednesday 25 june 2025 (Les biais cognitifs)
DOI number : 10.26299//2025.24.05
Abstract
During a surgical procedure, a patient under general anesthesia suddenly experiences a decline in vital signs: oxygen saturation drops, blood pressure collapses. The anesthesia team, under pressure and influenced by the patient’s asthmatic history, diagnoses a bronchospasm. Treatments are administered (bronchodilators, adrenaline…) but the patient’s condition does not improve. An external nurse arrives. With a fresh perspective, she surveys the scene, follows the trail of clues, and uncovers an unexpected cause: a simple kink in the intubation tube. With one swift action, the problem is resolved.
This incident highlights the powerful influence of cognitive biases (particularly confirmation bias combined with tunnel vision) that can mislead even experienced professionals. To reduce these biases and their consequences, it is essential to provide targeted training for healthcare providers, including anesthetists and nurse anesthetists, helping them to identify and manage these biases through practical methods such as healthcare simulation, which replicates scenarios where such biases may occur.
Additionally, organizational solutions like checklists, reflective pauses (“slowing down”), and interprofessional collaboration are proven strategies to minimize the risk of error. This dual approach (combining individual training with improvements to the working environment) is key to reducing cognitive bias and enhancing patient safety in anesthesia and all surgical practices.
This incident highlights the powerful influence of cognitive biases (particularly confirmation bias combined with tunnel vision) that can mislead even experienced professionals. To reduce these biases and their consequences, it is essential to provide targeted training for healthcare providers, including anesthetists and nurse anesthetists, helping them to identify and manage these biases through practical methods such as healthcare simulation, which replicates scenarios where such biases may occur.
Additionally, organizational solutions like checklists, reflective pauses (“slowing down”), and interprofessional collaboration are proven strategies to minimize the risk of error. This dual approach (combining individual training with improvements to the working environment) is key to reducing cognitive bias and enhancing patient safety in anesthesia and all surgical practices.