A Familiar Working Environment Influences Surgeon's Stress in the Operating Room: A Multi-Specialty Prospective Cohort Study.

IF 7.5 1区 医学 Q1 SURGERY Annals of surgery Pub Date : 2024-10-01 DOI:10.1097/SLA.0000000000006543
Jake A Awtry, Sarah C Skinner, Léa Pascal, Stephanie Polazzi, Jean-Christophe Lifante, Antoine Duclos
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Abstract

Objective: To determine the influence of operating room familiarity on surgeon stress.

Background: Regulating surgeon stress may improve patient safety. This study evaluated how assisting surgeon and operating room familiarity influence intraoperative heart rate variability among surgeons.

Methods: Attending surgeons from seven specialties within four university hospitals in France were enrolled from 11/01/20-12/31/21. Vagal tone, an indicator of stress derived from heart rate variability, was assessed during the first five minutes after incision using the root mean square of successive differences (RMSSD). Higher RMSSD values indicate greater vagal tone. Team familiarity was quantified as the cumulative time the attending and assisting surgeons had operated together in the past, while operating rooms in which the surgeon conducted >10% of their operations were termed familiar. The effect of each on the RMSSD was assessed via a linear mixed-effect model adjusting for the random effect of the surgeon and possible confounders.

Results: Overall, 643 surgeries performed by 37 surgeons were included. Median surgeon age was 49 years, 29(78.4%) were male, and 22(59.5%) were professors. Surgeons spent an average of 21.2 hours with the assisting surgeon prior to surgery and conducted 585(91.0%) of their operations in a familiar operating room. For every 10 additional hours spent operating together, ln(RMSSD) significantly increased by 0.018 (95%CI: 0.003 to 0.033, P=0.016). Familiar operating rooms also tended to increase surgeon ln(RMSSD) [0.098 (95%CI: -0.007 to 0.203, P=0.068)].

Conclusion: Familiar assisting surgeons, and potentially operating rooms, increased surgeon vagal tone. Maintaining a stable operating room environment may improve surgeon stress and patient care.

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熟悉的工作环境会影响外科医生在手术室的压力:一项多专科前瞻性队列研究。
目的:确定手术室熟悉程度对外科医生压力的影响:确定手术室熟悉程度对外科医生压力的影响:背景:调节外科医生的压力可提高患者安全。本研究评估了辅助外科医生和手术室熟悉程度对外科医生术中心率变异性的影响:方法:在 11/01/20-12/31/21 期间,来自法国四所大学医院七个专业的外科医生参加了这项研究。根据心率变异性得出的压力指标--迷走神经张力,在切口后的前五分钟内使用连续差值的均方根(RMSSD)进行评估。RMSSD 值越高,迷走神经张力越强。团队熟悉度的量化标准是主刀医生和助手医生过去一起手术的累计时间,而外科医生在其中进行的手术超过 10% 的手术室被称为熟悉的手术室。通过线性混合效应模型评估了每种因素对RMSSD的影响,并调整了外科医生的随机效应和可能的混杂因素:共纳入 37 名外科医生实施的 643 例手术。外科医生年龄中位数为 49 岁,29 位(78.4%)为男性,22 位(59.5%)为教授。外科医生在手术前平均与辅助外科医生共事 21.2 小时,其中 585 例(91.0%)手术是在熟悉的手术室进行的。共同手术时间每增加 10 个小时,ln(RMSSD)就会显著增加 0.018 (95%CI: 0.003 to 0.033, P=0.016)。熟悉的手术室也倾向于增加外科医生的ln(RMSSD)[0.098 (95%CI: -0.007 to 0.203, P=0.068)]:结论:熟悉的辅助外科医生和潜在的手术室会增加外科医生的迷走神经张力。保持稳定的手术室环境可改善外科医生的压力和患者护理。
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来源期刊
Annals of surgery
Annals of surgery 医学-外科
CiteScore
14.40
自引率
4.40%
发文量
687
审稿时长
4 months
期刊介绍: The Annals of Surgery is a renowned surgery journal, recognized globally for its extensive scholarly references. It serves as a valuable resource for the international medical community by disseminating knowledge regarding important developments in surgical science and practice. Surgeons regularly turn to the Annals of Surgery to stay updated on innovative practices and techniques. The journal also offers special editorial features such as "Advances in Surgical Technique," offering timely coverage of ongoing clinical issues. Additionally, the journal publishes monthly review articles that address the latest concerns in surgical practice.
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