Kromberg Laurits Schou, Kildebro Niels Vinkel, Mortensen Laura Quitzau, Amirian Ilda, Rosenberg Jacob
Department of Anesthesiology, Holbaek Hospital, Holbaek, Denmark.
Department of Surgery, Herlev Hospital, University of Copenhagen, Herlev, Denmark.
J Surg Res. 2020 Jul;251:1-5. doi: 10.1016/j.jss.2020.01.007. Epub 2020 Feb 21.
Musculoskeletal fatigue and pain as a consequence of performing surgery is found in 70%-87% of surgeons. The aim of this study was to examine the effect of microbreaks on surgeons' performance and well-being during laparoscopic appendectomy.
The study was a blinded randomized crossover trial. Twelve surgeons were tested at three time points: Before surgery (baseline), after surgery without intervention, and after surgery where microbreaks were used every 10 min for 10 s. The musculoskeletal endurance test was used as the primary outcome. Performance was assessed by procedure length and a manual precision test. The surgeons' well-being was measured by level of exhaustion rated on the Borg CR10 scale and visual analog scale ratings for musculoskeletal discomfort in the neck, shoulders, back, wrists, and legs.
No significant differences were found in musculoskeletal endurance, procedure time, or the manual precision test. The level of exhaustion was significantly increased after both normal procedures (P = 0.01) and procedures with microbreaks (P = 0.03). However, no significant difference was found between the two (P = 0.25). There was a significant increase from baseline regarding self-reported musculoskeletal discomfort in the back, shoulders, and legs after surgery but no significant differences between procedures with and without microbreaks.
This study did not find a positive effect of microbreaks on laparoscopic appendectomy. Exhaustion and discomfort were present after surgery, demonstrating that short surgical procedures (less than 60 min) can result in fatigue in surgeons.
70%-87%的外科医生在手术后会出现肌肉骨骼疲劳和疼痛。本研究的目的是探讨微休息对腹腔镜阑尾切除术中医师表现和幸福感的影响。
本研究为双盲随机交叉试验。12名外科医生在三个时间点接受测试：手术前（基线）、无干预的手术后，以及每10分钟进行10秒微休息的手术后。肌肉骨骼耐力测试作为主要结果。通过手术时长和手动精度测试评估表现。通过Borg CR10量表的疲劳程度评分以及颈部、肩部、背部、手腕和腿部肌肉骨骼不适的视觉模拟量表评分来衡量外科医生的幸福感。
在肌肉骨骼耐力、手术时间或手动精度测试中未发现显著差异。正常手术后（P = 0.01）和有微休息的手术后（P = 0.03）疲劳程度均显著增加。然而，两者之间未发现显著差异（P = 0.25）。手术后自我报告的背部、肩部和腿部肌肉骨骼不适较基线有显著增加，但有微休息和无微休息的手术之间无显著差异。
本研究未发现微休息对腹腔镜阑尾切除术有积极影响。手术后出现疲劳和不适，表明短时间手术（少于60分钟）会导致外科医生疲劳。
