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Published in: Clinical Orthopaedics and Related Research® 2/2008

01-02-2008 | Original Article

Orthopaedic Surgeons’ Cardiovascular Response During Total Hip Arthroplasty

Authors: Marko Bergovec, MD, Dubravko Orlic, MD, PhD

Published in: Clinical Orthopaedics and Related Research® | Issue 2/2008

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Abstract

The literature contains limited and contradictory information regarding the amount of physical effort and/or emotional stress needed to perform surgery. We therefore investigated cardiovascular response to psychophysical stress in orthopaedic surgeons while they were performing surgery. We monitored 29 male orthopaedic surgeons from four university centers while they performed total hip arthroplasties. Changes in their cardiovascular parameters were recorded by ambulatory monitoring methods. Exercise stress testing of each participant was used as a control state. We compared the cardiovascular response during surgery to energy requirements of everyday activities. Preoperative and postoperative testing showed lower values of cardiovascular parameters than during physically less difficult parts of the operation; physically more difficult phases of the operation additionally increased the values of parameters. We concluded performing total hip arthroplasty increases surgeons’ cardiovascular parameters because of psychologic stress and physical effort. Excitement of the cardiovascular system during total hip arthroplasty appears similar to the excitement during moderate-intensity daily activities, such as walking the dog, leisurely bicycling, or climbing stairs.
Literature
1.
go back to reference Abildstrom SZ, Jensen BT, Agner E, Torp-Pedersen C, Nyvad O, Wachtell K, Ottesen MM, Kanters JK, BEAT Study Group. Heart rate versus heart rate variability in risk prediction after myocardial infarction. J Cardiovasc Electrophysiol. 2003;14:168–173.PubMedCrossRef Abildstrom SZ, Jensen BT, Agner E, Torp-Pedersen C, Nyvad O, Wachtell K, Ottesen MM, Kanters JK, BEAT Study Group. Heart rate versus heart rate variability in risk prediction after myocardial infarction. J Cardiovasc Electrophysiol. 2003;14:168–173.PubMedCrossRef
2.
go back to reference Ainsworth BE, Haskell WL, Leon AS, Jacobs DR Jr, Montoye HJ, Sallis JF, Paffenbarger RS Jr Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc. 1993;25:71–80.PubMedCrossRef Ainsworth BE, Haskell WL, Leon AS, Jacobs DR Jr, Montoye HJ, Sallis JF, Paffenbarger RS Jr Compendium of physical activities: classification of energy costs of human physical activities. Med Sci Sports Exerc. 1993;25:71–80.PubMedCrossRef
3.
go back to reference Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DR Jr, Schmitz KH, Emplaincourt PO, Jacobs DR Jr, Leon AS. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9 suppl):S498–504.PubMed Ainsworth BE, Haskell WL, Whitt MC, Irwin ML, Swartz AM, Strath SJ, O’Brien WL, Bassett DR Jr, Schmitz KH, Emplaincourt PO, Jacobs DR Jr, Leon AS. Compendium of physical activities: an update of activity codes and MET intensities. Med Sci Sports Exerc. 2000;32(9 suppl):S498–504.PubMed
4.
go back to reference American Thoracic Society/American College of Chest Physicians. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003;167:211–277.CrossRef American Thoracic Society/American College of Chest Physicians. ATS/ACCP Statement on cardiopulmonary exercise testing. Am J Respir Crit Care Med. 2003;167:211–277.CrossRef
5.
go back to reference Arnetz BB, Andreasson S, Strandberg M, Eneroth P, Kallner A. Comparison between surgeons and general practitioners with respect to cardiovascular and psychosocial risk factors among physicians. Scand J Work Environ Health. 1988;14:118–124.PubMed Arnetz BB, Andreasson S, Strandberg M, Eneroth P, Kallner A. Comparison between surgeons and general practitioners with respect to cardiovascular and psychosocial risk factors among physicians. Scand J Work Environ Health. 1988;14:118–124.PubMed
6.
go back to reference Becker WG, Ellis H, Goldsmith R, Kaye AM. Heart rates of surgeons in theatre. Ergonomics. 1983;26:803–807.PubMedCrossRef Becker WG, Ellis H, Goldsmith R, Kaye AM. Heart rates of surgeons in theatre. Ergonomics. 1983;26:803–807.PubMedCrossRef
7.
go back to reference Böhm B, Rötting N, Schwenk W, Grebe S, Mansmann U. A prospective randomized trial on heart rate variability of the surgical team during laparoscopic and conventional sigmoid resection. Arch Surg. 2001;136:305–310.PubMedCrossRef Böhm B, Rötting N, Schwenk W, Grebe S, Mansmann U. A prospective randomized trial on heart rate variability of the surgical team during laparoscopic and conventional sigmoid resection. Arch Surg. 2001;136:305–310.PubMedCrossRef
8.
go back to reference Branson JJ, Goldstein WM. Primary total hip arthroplasty. AORN J. 2003;78:947–953, 956–969; quiz 971–974. Branson JJ, Goldstein WM. Primary total hip arthroplasty. AORN J. 2003;78:947–953, 956–969; quiz 971–974.
9.
go back to reference Coelho JC, Precoma D, Campos AC, Marchesini JB, Pereira JC. Twenty-four-hour ambulatory electrocardiographic monitoring of surgeons. Int Surg. 1995;80:89–91.PubMed Coelho JC, Precoma D, Campos AC, Marchesini JB, Pereira JC. Twenty-four-hour ambulatory electrocardiographic monitoring of surgeons. Int Surg. 1995;80:89–91.PubMed
10.
go back to reference Cohen J. Statistical Power Analysis for Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum; 1988. Cohen J. Statistical Power Analysis for Behavioral Sciences. 2nd ed. Hillsdale, NJ: Lawrence Erlbaum; 1988.
11.
go back to reference Czyzewska E, Kiczka K, Czarnecki A, Pokinko P. The surgeon’s mental load during decision making at various stages of operations. Eur J Appl Physiol Occup Physiol. 1983;51:441–446.PubMedCrossRef Czyzewska E, Kiczka K, Czarnecki A, Pokinko P. The surgeon’s mental load during decision making at various stages of operations. Eur J Appl Physiol Occup Physiol. 1983;51:441–446.PubMedCrossRef
12.
go back to reference Demirtas Y, Tulmac M, Yavuzer R, Yalcin R, Ayhan S, Latifoglu O, Atabay K. Plastic surgeon’s life: marvelous for mind, exhausting for body. Plast Reconstr Surg. 2004;114:923–931; discussion 932–933. Demirtas Y, Tulmac M, Yavuzer R, Yalcin R, Ayhan S, Latifoglu O, Atabay K. Plastic surgeon’s life: marvelous for mind, exhausting for body. Plast Reconstr Surg. 2004;114:923–931; discussion 932–933.
13.
go back to reference Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–191.PubMed Faul F, Erdfelder E, Lang AG, Buchner A. G*Power 3: a flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behav Res Methods. 2007;39:175–191.PubMed
14.
go back to reference Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, Froelicher VF, Leon AS, Piña IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001;104:1694–1740.PubMedCrossRef Fletcher GF, Balady GJ, Amsterdam EA, Chaitman B, Eckel R, Fleg J, Froelicher VF, Leon AS, Piña IL, Rodney R, Simons-Morton DA, Williams MA, Bazzarre T. Exercise standards for testing and training: a statement for healthcare professionals from the American Heart Association. Circulation. 2001;104:1694–1740.PubMedCrossRef
15.
go back to reference Foster GE, Evans DF, Hardcastle JD. Heart-rates of surgeons during operations and other clinical activities and their modification by oxprenolol. Lancet. 1978;1:1323–1325.PubMedCrossRef Foster GE, Evans DF, Hardcastle JD. Heart-rates of surgeons during operations and other clinical activities and their modification by oxprenolol. Lancet. 1978;1:1323–1325.PubMedCrossRef
16.
go back to reference Goldman LI, McDonough MT, Rosemond GP. Stresses affecting surgical performance, learning: I: correlation of heart rate, electrocardiogram, and operation simultaneously recorded on videotapes. J Surg Res. 1972;12:83–86.PubMedCrossRef Goldman LI, McDonough MT, Rosemond GP. Stresses affecting surgical performance, learning: I: correlation of heart rate, electrocardiogram, and operation simultaneously recorded on videotapes. J Surg Res. 1972;12:83–86.PubMedCrossRef
17.
go back to reference Jétte M, Sidney K, Blümchen G. Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Clin Cardiol. 1990;13:555–565.PubMed Jétte M, Sidney K, Blümchen G. Metabolic equivalents (METS) in exercise testing, exercise prescription, and evaluation of functional capacity. Clin Cardiol. 1990;13:555–565.PubMed
18.
go back to reference Karcz M, Chojnowska L, Zareba W, Ruzyllo W. Prognostic significance of heart rate variability in dilated cardiomyopathy. Int J Cardiol. 2003;87:75–81.PubMedCrossRef Karcz M, Chojnowska L, Zareba W, Ruzyllo W. Prognostic significance of heart rate variability in dilated cardiomyopathy. Int J Cardiol. 2003;87:75–81.PubMedCrossRef
19.
go back to reference Lear SA, Brozic A, Myers JN, Ignaszewski A. Exercise stress testing: an overview of current guidelines. Sports Med. 1999;27:285–312.PubMedCrossRef Lear SA, Brozic A, Myers JN, Ignaszewski A. Exercise stress testing: an overview of current guidelines. Sports Med. 1999;27:285–312.PubMedCrossRef
20.
go back to reference McCraty R, Atkinson M, Tiller WA, Rein G, Watkins AD. The effects of emotions on short-term power spectrum analysis of heart rate variability. Am J Cardiol. 1995;76:1089–1093.PubMedCrossRef McCraty R, Atkinson M, Tiller WA, Rein G, Watkins AD. The effects of emotions on short-term power spectrum analysis of heart rate variability. Am J Cardiol. 1995;76:1089–1093.PubMedCrossRef
21.
go back to reference Pallant J. SPSS Survival Manual: A Step by Step Guide to Data Analysis using SPSS Version 12. 2nd ed. New York, NY: Open University Press; 2004. Pallant J. SPSS Survival Manual: A Step by Step Guide to Data Analysis using SPSS Version 12. 2nd ed. New York, NY: Open University Press; 2004.
22.
go back to reference Payne RL, Rick JT. Heart rate as an indicator of stress in surgeons and anaesthetists. J Psychosom Res. 1986;30:411–420.PubMedCrossRef Payne RL, Rick JT. Heart rate as an indicator of stress in surgeons and anaesthetists. J Psychosom Res. 1986;30:411–420.PubMedCrossRef
23.
go back to reference Payne RL, Rick JT, Smith GH, Cooper RG. Multiple indicators of stress in an ‘active’ job: cardiothoracic surgery. J Occup Med. 1984;26:805–808.PubMedCrossRef Payne RL, Rick JT, Smith GH, Cooper RG. Multiple indicators of stress in an ‘active’ job: cardiothoracic surgery. J Occup Med. 1984;26:805–808.PubMedCrossRef
25.
go back to reference Pieper SJ, Hammill SC. Heart rate variability: technique and investigational applications in cardiovascular medicine. Mayo Clin Proc. 1995;70:955–964.PubMedCrossRef Pieper SJ, Hammill SC. Heart rate variability: technique and investigational applications in cardiovascular medicine. Mayo Clin Proc. 1995;70:955–964.PubMedCrossRef
26.
go back to reference Rimpelä AH, Nurminen MM, Pulkkinen PO, Rimpelä MK, Valkonen T. Mortality of doctors: do doctors benefit from their medical knowledge? Lancet. 1987;1:84–86.PubMedCrossRef Rimpelä AH, Nurminen MM, Pulkkinen PO, Rimpelä MK, Valkonen T. Mortality of doctors: do doctors benefit from their medical knowledge? Lancet. 1987;1:84–86.PubMedCrossRef
27.
go back to reference Sandercock GR, Bromley PD, Brodie DA. The reliability of short-term measurements of heart rate variability. Int J Cardiol. 2005;103:238–247.PubMedCrossRef Sandercock GR, Bromley PD, Brodie DA. The reliability of short-term measurements of heart rate variability. Int J Cardiol. 2005;103:238–247.PubMedCrossRef
28.
go back to reference Stein PK, Bosner MS, Kleiger RE, Conger BM. Heart rate variability: a measure of cardiac autonomic tone. Am Heart J. 1994;127:1376–1381.PubMedCrossRef Stein PK, Bosner MS, Kleiger RE, Conger BM. Heart rate variability: a measure of cardiac autonomic tone. Am Heart J. 1994;127:1376–1381.PubMedCrossRef
29.
go back to reference Task Force of the European Society of Cardiology, the North American Society of Pacing Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation. 1996;93:1043–1065. Task Force of the European Society of Cardiology, the North American Society of Pacing Electrophysiology. Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation. 1996;93:1043–1065.
30.
go back to reference Yamamoto A, Hara T, Kikuchi K, Hara T, Fujiwara T. Intraoperative stress experienced by surgeons and assistants. Ophthalmic Surg Lasers. 1999;30:27–30.PubMed Yamamoto A, Hara T, Kikuchi K, Hara T, Fujiwara T. Intraoperative stress experienced by surgeons and assistants. Ophthalmic Surg Lasers. 1999;30:27–30.PubMed
31.
go back to reference Zipes DP, Libby P, Bonow RO, Braunwald E. (eds). Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 7th ed. Philadelphia, PA: Elsevier Saunders; 2005. Zipes DP, Libby P, Bonow RO, Braunwald E. (eds). Braunwald’s Heart Disease: A Textbook of Cardiovascular Medicine. 7th ed. Philadelphia, PA: Elsevier Saunders; 2005.
Metadata
Title
Orthopaedic Surgeons’ Cardiovascular Response During Total Hip Arthroplasty
Authors
Marko Bergovec, MD
Dubravko Orlic, MD, PhD
Publication date
01-02-2008
Publisher
Springer-Verlag
Published in
Clinical Orthopaedics and Related Research® / Issue 2/2008
Print ISSN: 0009-921X
Electronic ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-007-0037-y

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