Division of Surgery, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, United Kingdom.
Semin Thorac Cardiovasc Surg. 2012 Autumn;24(3):166-75. doi: 10.1053/j.semtcvs.2012.06.005.
Sleep deprivation and fatigue have long been linked with accidents in high-risk industries and serious errors in the medical profession, but their effects on surgical performance are less well understood. This article outlines the important functions that human sleep serves and describes the neurobehavioral effects of wakefulness extension and mental fatigue that are relevant to surgical performance, including attentional failure, risk taking, and decision-making bias. Methods used to explore the effects of sleep deprivation and fatigue on surgical performance, from laboratory studies to outcomes data, are discussed; the findings are summarized; and important deficiencies in the literature are highlighted. Future strategies to mitigate performance decline, such as novel assessment tools and countermeasures with proven efficacy, are presented, and their deployment is discussed in the context of key ethical principles.
睡眠剥夺和疲劳长期以来一直与高风险行业的事故和医疗行业的严重错误有关，但它们对手术表现的影响还不太清楚。本文概述了人类睡眠的重要功能，并描述了与手术表现相关的清醒延长和精神疲劳的神经行为影响，包括注意力衰竭、冒险行为和决策偏差。讨论了用于探索睡眠剥夺和疲劳对手术表现影响的方法，从实验室研究到结果数据，并总结了研究结果，突出了文献中的重要缺陷。提出了减轻绩效下降的未来策略，例如具有经过验证功效的新型评估工具和对策，并在关键伦理原则的背景下讨论了其部署。
