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Year : 2018  |  Volume : 1  |  Issue : 2  |  Page : 122-127

Intraoperative stress in spine surgery – Surgeon versus assistant

1 Department of Trauma, Orthopaedic, and Hand Surgery, Klinikum Suedstadt Rostock, Rostock, Germany
2 Department of Orthopaedic Surgery, Medical University Innsbruck, Innsbruck, Austria
3 Department of Emergency Medicine, Klinikum Suedstadt Rostock, Rostock, Germany

Correspondence Address:
Dr. Maximilian Reinhold
Department of Trauma, Orthopaedic, and Hand Surgery, Klinikum Suedstadt Rostock, Suedring 81, 18059 Rostock
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/isj.isj_1_18

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Background: This study was a prospective observational study to assess the cardiovascular response and effects of mental stress during spine surgery depending on the surgeon's (attending or lead surgeon) versus assistant's (resident) position. Methods: Stress-related cardiovascular parameters were measured during 101 spine surgical procedures of a 40-year-old fellowship-trained spine surgeon with 12 years of practice. A training computer, personal scale, and thermometer were used to record the duration of surgery, heart rate, weight loss, and calorie burn. Results: The average maximum heart rate as an attending surgeon (124 bpm) was significantly higher when compared to the resident's heart rate (99 bpm) (P < 0.05). A higher stress level resulted in an increasingly higher average maximum heart rate according to the complexity of surgery: “easy” (103 bpm, 1 h: 51 min), “moderate” (125 bpm, 2 h: 57 min), and “difficult” (131bpm, 3 h: 56 min). The mean loss of body fluids at an average room temperature of 20.4°C after surgery was −0.82 kg (0 to −2.3 kg). The mean loss of body weight was calculated with −1.12% at the attending versus −0.59% at the resident (P < 0.05). Conclusions: The observed cardiovascular stress levels were similar to those of a moderate-to-intense workout such as cycling. Long-lasting surgeries result in a weight loss equivalent to a mild dehydration ranging from −2% to −5% of body fluids. Increasing dehydration will eventually worsen someone's cognitive-, visual-, and motor skills. Results of this study suggest that the early rehydration and other strategies (two surgeons and staged procedures) are helpful to minimize risks associated with prolonged, complex spine surgeries.

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