The goal of this observational study is to measure the cognitive load (mental effort) of anesthesia nurses during real surgical procedures at Hospital Clínic de Barcelona, Spain. The main questions it aims to answer are:
* Does cognitive load vary across the three phases of anesthetic care (induction, maintenance, and emergence/recovery)? * Is cognitive load higher during general anesthesia than during spinal anesthesia with sedation? * How do surgical specialty and patient complexity relate to cognitive load? * How does monitor alarm perception relate to cognitive load during surgery?
Participants (anesthesia nurses) will complete the NASA Task Load Index (NASA-TLX) questionnaire - a validated 6-item tool measuring mental effort - three times per surgical case: after induction or spinal block, during maintenance, and after patient awakening or sedation reversal. They will also answer 4 brief questions about alarm management at the end of each case. No changes are made to clinical care. Participation adds approximately 11 minutes per surgical case.
Registered nurse anesthetist actively working at Hospital Clínic de Barcelona.
Minimum 3 months in the current anesthesia nursing position.
Voluntary participation with signed informed consent.
Scheduled surgery (including deferred urgent surgery) or solid organ transplantation.
Refusal to participate or withdrawal of informed consent.
Spinal anesthesia without sedation.
Exclusive regional anesthesia without sedation.
Sedation alone without regional technique.