How Does Surgeons' Autonomic Physiology Vary Intraoperatively?: A Real-time Study of Cardiac Reactivity

Area of Science:

• Physiology
• Surgical Stress Response
• Autonomic Nervous System

Background:

• Intraoperative physiological responses offer insights into stress during surgery.
• Factors like operation complexity, surgical phase, and surgeon seniority influence stress levels.

Purpose of the Study:

• To measure physiological responses of surgical team members under varying intraoperative risk levels.
• To investigate the impact of professional role, operative risk, and primary operator on autonomic nervous system responses.

Main Methods:

• Continuous measurement of autonomic nervous system responses (interbeat intervals, IBIs) during diverse surgical operations.
• Analysis of IBI reactivity and physiological synchrony in relation to professional role, operative risk, and operator type.

Main Results:

• Attending surgeons exhibited greater IBI reactivity than residents and nurses during high-risk operations.
• Residents showed decreased reactivity during high-risk operations, while nurses' responses were similar across risk levels.
• Physiological synchrony varied, with attending surgeons showing negative covariation with residents and nurses in high-risk scenarios.

Conclusions:

• Attending surgeons' physiological responses are well-calibrated to operative demands, suggesting acquired risk sensitivity.
• Residents and nurses demonstrated less calibrated responses, indicating a developmental aspect to stress adaptation in surgery.