Chandra Tejasvini, Khan Perwez, Khan Lubna
Department of Ophthalmology, GSVM Medical College and LLR Hospital, Kanpur, India.
Department of Pathology, Department of Transfusion Medicine, GSVM Medical College and LLR Hospital, Kanpur, India.
Clin Ophthalmol. 2020 Oct 28;14:3535-3540. doi: 10.2147/OPTH.S266501. eCollection 2020.
To assess and quantify the stress in two different groups of ophthalmic surgeons while performing cataract surgery.
This is a prospective observational institutional study. Healthy ophthalmic surgeons (4 trainee surgeons and 4 consultants) and 4 OT assistants without any history of systemic illness were studied while performing uncomplicated and uneventful cataract surgery. Resting state and post-operative (immediately after surgery) systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse rate (PR), and oxygen saturation (SPO2) were measured by a Comen C80 multi-parameter monitor. Blood cortisol levels were measured by chemiluminescent assay (CLIA) and urine catecholamines levels (adrenaline, nor-adrenaline and dopamine) were measured by high performance liquid chromatography (HPLC). For assessment of stress among one group, paired -test is used and for comparison of stress levels between trainee surgeons and consultants unpaired -test is used.
Consultants performed phacoemulsification and trainee surgeons performed small incision cataract surgery. In both the groups, the post-operative values of SBP, DBP, PR, blood cortisol, and urine catecholamines were significantly higher than the pre-operative values. This difference was statistically significant. There was a significantly higher increase in SBP, DBP, PR, blood cortisol, urine adrenaline, and urine dopamine in trainee surgeons as compared to consultants whereas there was a significantly higher increase in urine nor-adrenaline in consultants as compared to trainee surgeons.
Our study reveals that every surgeon is under stress irrespective of experience though the level of stress is different among surgeons.
评估并量化两组不同眼科医生在进行白内障手术时的压力。
这是一项前瞻性观察性机构研究。对健康的眼科医生(4名实习医生和4名顾问医生)以及4名无任何全身性疾病史的手术室助手在进行简单且顺利的白内障手术时进行研究。通过科曼C80多参数监护仪测量静息状态和术后(手术刚结束后)的收缩压(SBP)、舒张压(DBP)、脉搏率(PR)和血氧饱和度(SPO2)。采用化学发光免疫分析法(CLIA)测量血皮质醇水平,采用高效液相色谱法(HPLC)测量尿儿茶酚胺水平(肾上腺素、去甲肾上腺素和多巴胺)。对于一组压力的评估,采用配对t检验,对于实习医生和顾问医生之间压力水平的比较,采用非配对t检验。
顾问医生进行超声乳化白内障吸除术,实习医生进行小切口白内障手术。两组中,术后SBP、DBP、PR、血皮质醇和尿儿茶酚胺的值均显著高于术前值。这种差异具有统计学意义。与顾问医生相比,实习医生的SBP、DBP、PR、血皮质醇、尿肾上腺素和尿多巴胺升高更为显著,而与实习医生相比,顾问医生的尿去甲肾上腺素升高更为显著。
我们的研究表明,每位外科医生都处于压力之下,无论经验如何,尽管不同外科医生的压力水平有所不同。