A Comparison of Cardiac Surgeon’s Stress Level
The off-pump cardiac surgeries can be beneficial to the patent by causing less mortality, stroke and atrial fibrillation, compared to on-pump; however, the mental strain imposed on the cardiac surgeon during off-pump operations in contrast to on-pump ones has not been previously investigated and recent studies have cast doubt on its effectiveness in graft patency. Off-pump procedures can be more exhausting to a cardiac surgeon, especially while grafting the posterior coronaries (LCX, OM), when there is a risk of hemodynamic changes and loss of the patient.
One of the more favourable methods in evaluating mental stress is the heart variability, which is a balance between the sympathetic and parasympathetic nervous systems. The heart rate variability indices consist of heart rate, low frequency (LF), high frequency (HF), and low frequency/ high frequency ratio (LF/HF). The HF spectral component is the result of the parasympathetic system and the LF/HF is controlled by the sympathetic system, but there is controversy over the LF inasmuch as some regard sympathetic modulation and others consider the effect of both sympathetic and parasympathetic nervous systems as being responsible for its generation. Amongst these indices, the LF/HF ratio has been proposed as a non-invasive quantitative measure of the autonomic nervous system activity and is a favoured measurement of stress level.
Seeking to test the hypothesis that off-pump CABG leads to a more pronounced strain and mental stress for the operator compared to on-pump CABG, we utilized the popular method of the heart rate variability indices of the surgeon while performing these two types of surgical operations. The heart rate indices of a cardiac surgeon were monitored throughout 17 on-pump and 16 off-pump CABGs. The surgical operations were performed between May 2009 and July 2009. The exclusion criteria were surgeries in which the surgeon had slept less than 7 hours during the previous night or when he had an unexpected stress during the previous 12 hours. The procedures with concomitant valve surgeries were also excluded. Informed written consent was obtained from all the patients, and the study protocol was approved by our institutional Ethics Committee on Human Study.
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Current Issue: Volume 11, Issue 9
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Journal of Clinical and Experimental Cardiology