Do Micropauses Prevent Surgeon Fatigue in Prolonged Surgery?
Do Micropauses Prevent Surgeon Fatigue in Prolonged Surgery?
Objective This prospective experimental study evaluates the effectiveness of micropauses (MPs) to prevent muscular fatigue and its deleterious effect on surgeons during prolonged surgical procedures.
Background Operating is a hazard for surgeon's health. Beyond acute injuries and blood-borne infections, back and neck pain is a poorly recognized factor causing chronic ailment in more than half the surgeons surveyed. MP, a 20-second break every 20 minutes, is an accepted strategy used widely in the workplace.
Methods We designed a crossover experimental study. Sixteen surgeons were tested 3 times: once in a control situation before any surgery (CTL) and twice after a prolonged, reproducible operation (at least 2 hours), 1 of these with formal MP (WMP) the other without (WOMP). Muscular fatigue was tested by holding a 2.5-kg weight as long as possible with a stretched arm. Accuracy was evaluated with a device, measuring the mistakes made when following a predetermined path on a board. Finally, discomfort was measured by visual analog scale.
Results We found a statistically and more importantly clinically significant difference between the CTL and WOMP groups in all 3 tests. MPs prevented completely or almost completely the effects of fatigue associated with surgery [accuracy (No. errors) CTL: 1.1, WOMP: 7.7, WMP: 1.7; fatigue (seconds) CTL: 137, WOMP: 92, WMP: 142].
Conclusions Surgical procedures are associated with significant muscular fatigue that can be measured simply and which has a direct effect on comfort and surgical accuracy. More important, this effect is completely or almost completely prevented by MPs.
Operating is a hazard for a surgeon's health. Beyond acute injuries and blood-borne infections, back and neck pain is a poorly recognized factor potentially causing chronic ailment. Although it is an established occupational disease for many professions, very few studies have looked at the prevalence of this problem among surgeons. Babar-Craig and collaborators found a prevalence of 72% of back or neck pain or even both among otolaryngologists in the United Kingdom. Of those with pain, 53% attributed their symptoms directly to surgery. This certainly demonstrates a lack of adequate training, and improvement is needed to prevent long-term disability. Beyond this, we were also concerned with the immediate effects of prolonged surgery on technical performance. Although these issues are new in the health care environment, ergonomics in the workplace have certainly been studied extensively in the last 50 years. Micropause (MP), a formal 20-second break every 20 minutes of work, is a widely accepted strategy to optimize performance, especially in sedentary work, for example, working in front of a computer. The objective of this research project was, therefore, to test our hypothesis that MP would (a) decrease the feeling of discomfort and (b) improve strength and (c) precision by comparing the performance of surgeons who had or had not taken MP during a long procedure.
Abstract and Introduction
Abstract
Objective This prospective experimental study evaluates the effectiveness of micropauses (MPs) to prevent muscular fatigue and its deleterious effect on surgeons during prolonged surgical procedures.
Background Operating is a hazard for surgeon's health. Beyond acute injuries and blood-borne infections, back and neck pain is a poorly recognized factor causing chronic ailment in more than half the surgeons surveyed. MP, a 20-second break every 20 minutes, is an accepted strategy used widely in the workplace.
Methods We designed a crossover experimental study. Sixteen surgeons were tested 3 times: once in a control situation before any surgery (CTL) and twice after a prolonged, reproducible operation (at least 2 hours), 1 of these with formal MP (WMP) the other without (WOMP). Muscular fatigue was tested by holding a 2.5-kg weight as long as possible with a stretched arm. Accuracy was evaluated with a device, measuring the mistakes made when following a predetermined path on a board. Finally, discomfort was measured by visual analog scale.
Results We found a statistically and more importantly clinically significant difference between the CTL and WOMP groups in all 3 tests. MPs prevented completely or almost completely the effects of fatigue associated with surgery [accuracy (No. errors) CTL: 1.1, WOMP: 7.7, WMP: 1.7; fatigue (seconds) CTL: 137, WOMP: 92, WMP: 142].
Conclusions Surgical procedures are associated with significant muscular fatigue that can be measured simply and which has a direct effect on comfort and surgical accuracy. More important, this effect is completely or almost completely prevented by MPs.
Introduction
Operating is a hazard for a surgeon's health. Beyond acute injuries and blood-borne infections, back and neck pain is a poorly recognized factor potentially causing chronic ailment. Although it is an established occupational disease for many professions, very few studies have looked at the prevalence of this problem among surgeons. Babar-Craig and collaborators found a prevalence of 72% of back or neck pain or even both among otolaryngologists in the United Kingdom. Of those with pain, 53% attributed their symptoms directly to surgery. This certainly demonstrates a lack of adequate training, and improvement is needed to prevent long-term disability. Beyond this, we were also concerned with the immediate effects of prolonged surgery on technical performance. Although these issues are new in the health care environment, ergonomics in the workplace have certainly been studied extensively in the last 50 years. Micropause (MP), a formal 20-second break every 20 minutes of work, is a widely accepted strategy to optimize performance, especially in sedentary work, for example, working in front of a computer. The objective of this research project was, therefore, to test our hypothesis that MP would (a) decrease the feeling of discomfort and (b) improve strength and (c) precision by comparing the performance of surgeons who had or had not taken MP during a long procedure.
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