title: Intraoperative pulse and blood pressure recordings of neurosurgeons: a pilot study of cardiovascular performance.
abstract: BACKGROUND
  Although hemodynamic changes in anesthetized patients remain well documented, no study has quantified the effect of operating stress on the neurosurgeon.
  
  
  OBJECTIVE
  We present a study of intraoperative (IOP) pulse and blood pressure (BP) recordings obtained from neurosurgeons and compare them with rest and exercise values.
  
  
  METHODS
  This prospective, single-blind comparative analysis used an ambulatory BP device to record IOP, rest and exercise BP, and pulse. The Student t test and chi test were used for statistical analysis.
  
  
  RESULTS
  Five neurosurgeons performed 10 aneurysm clippings and 1 vestibular schwannoma excision. The average IOP pooled systolic, diastolic, and mean BPs and pulse rates were 140, 103, and 116 mm Hg and 94 bpm, respectively. Corresponding rest and exercise values were 116, 75, and 89 mm Hg and 76 bpm and 130, 99, and 109 mm Hg and 128 bpm, respectively. Average IOP mean and diastolic BPs were significantly elevated compared with rest readings (P = .032, P = .023). Episodes of severe IOP BP (systolic BP/diastolic BP > 180/110 mm Hg) accounted for 28% of all readings and were significantly increased over rest values (P < .001). The incidence of abnormal IOP BP (systolic BP/diastolic BP > 140/90 mm Hg) was also significantly greater than exercise and rest values (P < .001).
  
  
  CONCLUSIONS
  Neurosurgery can induce a significant hemodynamic stress malresponse in the operating surgeon that appears to be greater than that induced by vigorous exercise. The correlation of this occupational hazard to long-term health and longevity remains to be studied.
authors.affiliation: Department of Neurosurgery, India Institute of Medical Sciences, New Delhi 110029, India. manishsinghsharma@gmail.com
authors.forename: Manish Singh
authors.initials: MS
authors.lastname: Sharma
authors.forename: Amit
authors.initials: A
authors.lastname: Thapa
authors.forename: Sharat P
authors.initials: SP
authors.lastname: Chandra
authors.forename: Ashish
authors.initials: A
authors.lastname: Suri
authors.forename: Manmohan
authors.initials: M
authors.lastname: Singh
authors.forename: Vinay K
authors.initials: VK
authors.lastname: Bahl
authors.forename: Bhawani S
authors.initials: BS
authors.lastname: Sharma
mesh_terms: D001794:Blood Pressure / Q000502:physiology*; D002320:Cardiovascular Physiological Phenomena; D006801:Humans; D007432:Intraoperative Period; D009493:Neurosurgery; D016272:Occupational Health; D010820:Physicians; D010865:Pilot Projects; D011674:Pulse; D013315:Stress, Psychological / Q000503:physiopathology*