A prospective randomized trial on heart rate variability of the surgical team during laparoscopic and conventional sigmoid resection.
OBJECTIVE
Mental strain measured by heart rate variability differs during laparoscopic and conventional sigmoid resections.


METHODS
Prospective randomized study.


METHODS
University hospital.


METHODS
Two surgeons performed 10 conventional and 10 laparoscopic sigmoid resections, alternating roles as primary surgeon and assistant. The kind of technique was randomly chosen each time.


METHODS
Electrocardiograms of the surgeon and assistant were continuously recorded during the procedures and heart rate variability was analyzed off-line. The first 10 procedures (5 laparoscopic and 5 conventional) were performed by the more experienced and the next 10 by the less experienced surgeon.


METHODS
Heart rate variability was determined by power spectral analysis as heart rate in beats per minute, high frequency (HF) and low frequency (LF) components in normalized units, and LF/HF ratio.


RESULTS
Results are given for heart rate, HF, LF, and LF/HF ratio for the following variables: laparoscopic surgery: 87.9, 14.7, 90.1, 7.5; conventional surgery: 90.2, 17.1, 87.6, 6.4; surgeon: 94.0, 13.5, 91.4, 8.4; first assistant: 84.1, 17.8, 86.3, 5.6; more experienced surgeon: 93.1, 16.5, 87.8, 6.4; and less experienced surgeon: 85.0, 14.8, 90.0, 7.5. The LF/HF ratio was significantly higher (P<.05) for laparoscopic compared with conventional surgery and for the surgeon compared with the assistant (P<.001), but not between the less and the more experienced surgeons.


CONCLUSIONS
Performing laparoscopic colorectal surgery causes higher mental strain in surgeons than performing conventional surgery.
Department of General, Visceral, Vascular and Thoracic Surgery, Charité, Campus Mitte, Humboldt University, Schumannstr, 20-21, D-10117 Berlin, Germany. bboehm@charite.de
B
B
Böhm
N
N
Rötting
W
W
Schwenk
S
S
Grebe
U
U
Mansmann
D001143:Arousal / Q000502:physiology*; D012809:Colon, Sigmoid / Q000601:surgery*; D004562:Electrocardiography; D005583:Fourier Analysis; D013502:General Surgery; D006339:Heart Rate / Q000502:physiology*; D006801:Humans; D010535:Laparoscopy; D009784:Occupational Diseases / Q000503:physiopathology*; D011446:Prospective Studies; D012815:Signal Processing, Computer-Assisted; D013315:Stress, Psychological / Q000150:complications / Q000503:physiopathology