Quantification of surgical stress showed how experience affects emotional control and physiological parameters such as heart rate and breathing rate. Also, in beginner surgeons, stress progressively decreases throughout the day as they perform subsequent operations. At the Hanusch Hospital in Vienna, a study was performed to assess stress levels of both patients and surgeons during cataract procedures. The Neuromaster system was used to measure stress parameters such as sweating, heart rate and respiration. “In patients, we could see that stress level was reduced during the second eye procedure, which might explain why, conversely, they are more sensitive to pain and discomfort,” Stefan Palkovits, MD, said at the European Society of Cataract and Refractive Surgeons winter meeting. Three surgeons with different levels of experience were included. Stress parameters were first measured during a mathematical test and then during four consecutive cataract operations over 1 day. Surgeons also provided subjective assessment of stress on a scale from 1 to 10. “All stress indicators increased during the math test in a similar way for the three surgeons. During surgery, the experienced surgeon showed stable heart rate and breathing, with a slight increase during phacoemulsification and IOL implantation,” Palkovits said. Both the intermediate and beginner surgeons showed significant variations, with peaks during capsulorrhexis, phacoemulsification and IOL implantation, and whenever something unexpected occurred, such as the handling of a new instrument or an IOL in which the haptics had initial difficulty in unfolding. The first surgery of the day was the worst, and stress progressively decreased during the following procedures. Subjective stress evaluation matched the objective findings. “Interestingly, surgery for the experienced surgeon was less stressful than the math test, which consisted of a simple operation,” Palkovits said. – by Michela Cimberle Source
