Intraoperative heart rate variability of a cardiac surgeon himself in coronary artery bypass grafting surgery.
The mental strain of a cardiac surgeon may differ when he performs coronary surgery from and when he only assists in performing coronary surgery. In 50 selected cases of on-pump heart arrested coronary artery bypass grafting (CABG), an attending-consultant surgeon performed 30 procedures of CABG (Group A) and an attending-consultant surgeon supervised the remaining 20 cases of CABG performed by two resident surgeons (Group B). Intraoperative Holter electrocardiograms of the attending-consultant surgeon were recorded and analyzed for heart rate variability (HRV). In Group A, the ratio of low frequency to high frequency was at a peak in the beginning of the operation and gradually decreased toward the end of the operation. In Group B, the ratio of low frequency to high frequency was at a peak in the phase of aortic cross-clamp, coronary anastomosis, and unclamping. When an attending-consultant surgeon performed the operation himself, the most anxious part of the operation was at the beginning and thereafter the level of anxiety gradually declined. In contrast, when he assisted a resident, the highest level of anxiety was when the aortic cross-clamp was in place and out of place and during the coronary anastomosis.
Song
Min-Ho
MH
Department of Cardiovascular Surgery, Gifu Prefectural Tajimi Hospital, Tajimi, Gifu, Japan. son-minho@pref.gifu.lg.jp
Tokuda
Yoshiyuki
Y
Nakayama
Tomohiro
T
Sato
Masami
M
Hattori
Keisuke
K
D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology / Q000503:physiopathology*; D002983:Clinical Competence; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality / Q000523:psychology*; D015716:Electrocardiography, Ambulatory; D005260:Female; D006339:Heart Rate; D006801:Humans; D007396:Internship and Residency; D008297:Male; D008875:Middle Aged; D009873:Operating Rooms; D010820:Physicians / Q000523:psychology*; D013315:Stress, Psychological / Q000209:etiology / Q000503:physiopathology*