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Do Micropauses Prevent Surgeon's Fatigue and Loss of Accuracy Associated With Prolonged Surgery? An Experimental Prospective Study

Dorion, Dominique MD, MSc,; Darveau, Simon MD

doi: 10.1097/SLA.0b013e31825efe87
Original Articles

Objective: This prospective experimental study evaluates the effectiveness of micropauses (MPs) to prevent muscular fatigue and its deleterious effect on surgeons during prolonged surgical procedures.

Background: Operating is a hazard for surgeon's health. Beyond acute injuries and blood-borne infections, back and neck pain is a poorly recognized factor causing chronic ailment in more than half the surgeons surveyed. MP, a 20-second break every 20 minutes, is an accepted strategy used widely in the workplace.

Methods: We designed a crossover experimental study. Sixteen surgeons were tested 3 times: once in a control situation before any surgery (CTL) and twice after a prolonged, reproducible operation (at least 2 hours), 1 of these with formal MP (WMP) the other without (WOMP). Muscular fatigue was tested by holding a 2.5-kg weight as long as possible with a stretched arm. Accuracy was evaluated with a device, measuring the mistakes made when following a predetermined path on a board. Finally, discomfort was measured by visual analog scale.

Results: We found a statistically and more importantly clinically significant difference between the CTL and WOMP groups in all 3 tests. MPs prevented completely or almost completely the effects of fatigue associated with surgery [accuracy (No. errors) CTL: 1.1, WOMP: 7.7, WMP: 1.7; fatigue (seconds) CTL: 137, WOMP: 92, WMP: 142].

Conclusions: Surgical procedures are associated with significant muscular fatigue that can be measured simply and which has a direct effect on comfort and surgical accuracy. More important, this effect is completely or almost completely prevented by MPs.

Surgical procedures are associated with significant muscular fatigue that can be measured simply and which has a direct effect on comfort and surgical accuracy. More important, this effect is completely or almost completely prevented by micropauses (a 20-second break every 20 minutes).

Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, University of Sherbrooke, Sherbrooke, Quebec, Canada.

Reprints: Dominique Dorion, MD, MSc, Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, University of Sherbrooke, 3001, 12th Ave N, Sherbrooke, Quebec J1H 5N4, Canada. E-mail: Dominique.Dorion@USherbrooke.ca.

Disclosure: The authors have no conflicts of interest to report. However, the project was funded in part by the Department of Surgery, University of Sherbrooke.

© 2013 Lippincott Williams & Wilkins, Inc.