Acute mental stress and surgical performance

Abstract

BackgroundStress has been shown to impact adversely on multiple facets critical to optimal performance. Advancements in wearable technology can reduce barriers to observing stress during surgery. This study aimed to investigate the association between acute intraoperative mental stress and technical surgical performance.MethodsContinuous electrocardiogram data for a single attending surgeon were captured during surgical procedures to obtain heart rate variability (HRV) measures that were used as a proxy for acute mental stress. Two different measures were used: root mean square of successive differences (RMSSD) and standard deviation of RR intervals (SDNN). Technical surgical performance was assessed on the Operating Room Black Box® platform using the Generic Error Rating Tool (GERT). Both HRV recording and procedure video recording were time‐stamped. Surgical procedures were fragmented to non‐overlapping intervals of 1, 2 and 5 min, and subjected to data analysis. An event was defined as any deviation that caused injury to the patient or posed a risk of harm.ResultsRates of events were significantly higher (47–66 per cent higher) in the higher stress quantiles than in the lower stress quantiles for all measured interval lengths using both proxy measures for acute mental stress. The strongest association was observed using 1‐min intervals with RMSSD as the HRV measure (P < 0·001).ConclusionThere is an association between measures of acute mental stress and worse technical surgical performance. Further study will help delineate the interdependence of these variables and identify triggers for increased stress levels to improve surgical safety.

The effect of preferred music on mental workload and laparoscopic surgical performance in a simulated setting (OPTIMISE): a randomized controlled crossover study

“…Short-term HRV measurements [31], lasting approximately five minute during each of the four periods as well as the first five and last five minutes of the preparation phase, were analyzed (ATS 2.4.6., BM Innovations). HRV can represent the physiological state of autonomic nervous system activity and has been used to assess mental strain in surgeons during laparoscopic task performance [32]. A lower HRV implicates dominance by the sympathetic nervous system and has been regarded as higher mental strain.…”

Design of a Wearable System to Capture Physiological Data to Monitor Surgeons’ Stress During Surgery

“…In order to attain feedback regarding the potential comfort and acceptability of candidate architectures, based on commercial wearable devices for purposes ranging from meditation to sleep to exercising [14][15][16][17][18], a survey was conducted to evaluate potential sensor placements. Proposed designs included a chest band, a "necklace," attached to underwear, an arm band and others.…”

“…Individual wearable bio sensors are available, in both clinical and consumer forms; however, no single device exists that meets all the requirements in an operating room (OR) *N. Z. Jia (zixunjia@mit.edu), D. Mejorado (dmejorad@mit.edu), S. Poullados (sdp16@mit.edu), N. Hanumara (+1.617.258.85641, hanumara@mit.edu) and G. Traverso (cgt20@mit.edu) are with the Massachusetts Institute of Technology, Cambridge, MA 02139, USA. setting including: unobtrusiveness, measurement of a comprehensive set of biological signals that correlate with stress, and reliable data storage for integration into a data processing pipeline [14][15][16][17][18]. A device that only measures a single physiological signal lacks comprehensiveness.…”

Variabilidade da Frequência Cardíaca como biomarcador do estresse: revisão integrativa

“…A indução do estresse psicossocial e mental deu-se pelo estresse psicossocial (antes da realização dos exames finais) (Visnovcova, et al, 2015), Beck Depression Inventory (BDI) e estresse emocional (Tonhajzerova, et al, 2016), condições de estresse induzidas pelo teste de inclinação da cabeça para cima e aritmética mental (Javorka, et al, 2017). Estresse e desempenho cirúrgico foram coletados para um cirurgião assistente durante os procedimentos (Grantcharov, et al, 2018).…”