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Do micropauses prevent surgeon's fatigue and loss of accuracy associated with prolonged surgery? An experimental
Dominique Dorion1, Simon Darveau
1Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, University of Sherbrooke, Sherbrooke, Quebec, Canada. Dominique.Dorion@USherbrooke.ca
Objective:
This prospective experimental study evaluates the effectiveness of micropauses (MPs) to prevent muscular fatigue and its deleterious effect on surgeons during prolonged surgical procedures.
Background:
Operating is a hazard for surgeon's health. Beyond acute injuries and blood-borne infections, back and neck pain is a poorly recognized factor causing chronic ailment in more than half the surgeons surveyed. MP, a 20-second break every 20 minutes, is an accepted strategy used widely in the workplace.
Methods:
We designed a crossover experimental study. Sixteen surgeons were tested 3 times: once in a control situation before any surgery (CTL) and twice after a prolonged, reproducible operation (at least 2 hours), 1 of these with formal MP (WMP) the other without (WOMP). Muscular fatigue was tested by holding a 2.5-kg weight as long as possible with a stretched arm. Accuracy was evaluated with a device, measuring the mistakes made when following a predetermined path on a board. Finally, discomfort was measured by visual analog scale.
Results:
We found a statistically and more importantly clinically significant difference between the CTL and WOMP groups in all 3 tests. MPs prevented completely or almost completely the effects of fatigue associated with surgery [accuracy (No. errors) CTL: 1.1, WOMP: 7.7, WMP: 1.7; fatigue (seconds) CTL: 137, WOMP: 92, WMP: 142].
Conclusions:
Surgical procedures are associated with significant muscular fatigue that can be measured simply and which has a direct effect on comfort and surgical accuracy. More important, this effect is completely or almost completely prevented by MPs.
Insights
Micropauses (MPs), short 20-second breaks every 20 minutes, significantly reduce surgeon fatigue and improve accuracy during prolonged surgeries. This simple intervention combats muscular fatigue and enhances surgical performance.
Area of Science:
- Surgical Science
- Occupational Health
- Ergonomics
Background:
- Prolonged surgical procedures pose risks to surgeon health, including chronic back and neck pain.
- Muscular fatigue is a significant, often overlooked, factor impacting surgeon well-being and performance.
- Micropauses (MPs), defined as 20-second breaks every 20 minutes, are an established workplace strategy.
Purpose of the Study:
- To evaluate the effectiveness of micropauses (MPs) in preventing muscular fatigue in surgeons.
- To assess the impact of MPs on surgical accuracy and surgeon discomfort during extended operations.
Main Methods:
- A crossover experimental design was employed with 16 surgeons.
- Surgeons underwent three testing conditions: control (CTL), surgery without micropauses (WOMP), and surgery with micropauses (WMP).
- Muscular fatigue, accuracy, and discomfort were measured using standardized tests and visual analog scales.
Main Results:
- A statistically significant difference was observed between CTL and WOMP groups across all measured parameters.
- Micropauses (WMP) effectively prevented or nearly eliminated the negative effects of surgical fatigue on accuracy and endurance.
- Accuracy improved from 7.7 errors (WOMP) to 1.7 errors (WMP), and fatigue duration increased from 92 seconds (WOMP) to 142 seconds (WMP).
Conclusions:
- Surgical procedures induce measurable muscular fatigue, impacting surgeon comfort and accuracy.
- Micropauses are a highly effective intervention, completely or almost completely preventing the detrimental effects of fatigue.
- Implementing MPs can enhance surgeon well-being and improve patient safety through sustained surgical performance.
