Background: The effect of acute partial sleep deprivation on surgical proficiency is still controversially discussed. The present study correlated physiological parameters of fatigue with objective technical and cognitive skills, as well as subjective sleepiness of surgical residents. The aim of the study was to assess the effect of acute partial sleep deprivation on surgical performance.
Methods: Thirty-eight surgeons were interviewed on three consecutive mornings: prior to a 24 h call, post-call, and after 24 h of rest. Reported hours of sleep were recorded. Subjective alertness was assessed with the standardized Stanford-Sleepiness-Scale (SSS). Saliva cortisol concentrations and pupillary activity were measured by standardized ELISA and pupillography. The virtual reality (VR)-simulator LapSim was used to assess technical skills through low-fidelity VR-tasks ("cutting," "clip applying") and cognitive skills through high-fidelity VR-tasks ("intracorporeal suturing," "VR-cholecystectomy"). Objective alertness was measured by the standardized d2-Paper-Pencil Test.
Results: Recorded hours of sleep (p = 0.001) and subjective alertness (SSS) decreased (p = 0.001) significantly post-call. None of the three factors studied-saliva cortisol concentration (p = 0.313), pupillary activity (p = 0.998), or VR-performance of low-fidelity VR-tasks-differed significantly between assessments. Surprisingly, VR-performance of high-fidelity VR-tasks (error-score p = 0.044, time to complete task p = 0.0001, economy of instrument motion p = 0.0001) and objective alertness (d2-Paper-Pencil Test p = 0.027) significantly improved in the post-call setting.
Conclusions: Acute call-associated fatigue seems to be a predominantly subjective perception. Physiological factors seem to outbalance an anticipated fatigue-associated impairment of technical performances within low-fidelity VR-tasks. In surgical residents, acute partial sleep deprivation seems to have a positive short-term effect on cognitive skills, leading to enhanced technical performance and increased objective alertness within complex tasks.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1007/s00268-012-1699-5 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Short-term and long-term outcomes of lung transplantation from marginal donors: a single-center retrospective study.
J Thorac Dis
December 2024
Department of Thoracic Surgery, The Affiliated Wuxi People's Hospital of Nanjing Medical University, Wuxi, China.
Background: To expand the donor pool, medical centers worldwide are applying marginal donor lungs in clinical settings. We carried out this research to reveal the short-term and long-term outcomes of marginal lung donor transplantation.
Methods: We performed retrospective research using data from patients who underwent lung transplantation (LT) in The Affiliated Wuxi People's Hospital of Nanjing Medical University, Jiangsu Province, China, between 2018 and 2022 to compare the short-term and long-term outcomes of standard donors and marginal donors.
Prognostic analysis of acute type A aortic dissection after different surgical interventions: a cohort study.
J Thorac Dis
December 2024
Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, and Beijing Institute of Heart Lung and Blood Vessel Diseases, Beijing, China.
Background: Acute type A aortic dissection (ATAAD) requires emergency surgery, but the choice of primary surgery remains controversial. It is believed that simple ascending aorta replacement may lead to higher postoperative survival rate, while the Sun procedure [frozen elephant trunk (FET) + total arch replacement (TAR)] performed in the first stage may obtain better long-term results. The study aimed to compare the outcome of ATAAD patients who underwent the Sun procedure with those without TAR + FET.
View Article and Find Full Text PDFSafety and effectiveness in an uncontrolled setting of glucagon-like-peptide-1 receptor agonists in patients with familial partial lipodystrophy: Real-life experience from a national reference network.
Diabetes Obes Metab
January 2025
Endocrinology Department, Assistance Publique-Hôpitaux de Paris (AP-HP), Saint-Antoine University Hospital, National Reference Centre for Rare Diseases of Insulin Secretion and Insulin Sensitivity (PRISIS), Paris, France.
Aim: To describe the effects of Glucagon-like peptide-1 receptor agonists (GLP-1RA) in patients with familial partial lipodystrophy (FPLD) assessed in a real-life setting in a national reference network.
Patients And Methods: We retrospectively collected clinical and metabolic parameters in patients with FPLD in the French lipodystrophy reference network, who initiated GLP-1RA. Data were recorded before, at one-year (12 ± 6 months) and at the latest follow-up on GLP-1RA therapy (≥18 months).
Modified approach to external oblique intercostal block: a proof-of-concept pilot case series and anatomical evaluation.
Korean J Anesthesiol
January 2025
Department of Anesthesiology and Pain Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo, Japan.
Background: Regional anesthesia techniques that provide analgesia to the entire lateral abdomen are limited. We present a modified external oblique intercostal block for complete lateral abdominal analgesia with a single injection.
Case: We performed a modified version of the external oblique intercostal block unilaterally at the tenth rib along the mid-axillary line in three patients undergoing robot-assisted partial nephrectomy (two single injections, one catheter placement) and tested the technique on a cadaver with 20 ml of dye bilaterally.
Etiological spectrum and short-term outcomes of acute kidney injury in hospitalised patients of uncertain aetiology who underwent percutaneous renal biopsy.
J Pak Med Assoc
January 2025
Department of Nephrology, Sindh Institute of Urology and Transplantation, Karachi, Pakistan.
Objectives: To analyse the aetiological spectrum, clinical presentation and short-term renal outcomes of patients with acute kidney injury of uncertain aetiology subjected to percutaneous renal biopsy.
Methods: The prospective, cohort study was conducted at the Sindh Institute of Urology and Transplantation, Karachi, from March 1 to October 30, 2024, and comprised hospitalised acute kidney injury patients of either gender aged 18- 75 years who had been subjected to percutaneous renal biopsy. The patients were followed up for at least three months from the time of the biopsy.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!