title: Do micropauses prevent surgeon's fatigue and loss of accuracy associated with prolonged surgery? An experimental prospective study.
abstract: 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.
authors: Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, University of Sherbrooke, Sherbrooke, Quebec, Canada. Dominique.Dorion@USherbrooke.ca
authors: Dominique
authors: D
authors: Dorion
authors: Simon
authors: S
authors: Darveau
mesh_terms: D000328:Adult; D002983:Clinical Competence; D018592:Cross-Over Studies; D013502:General Surgery; D006801:Humans; D018763:Muscle Fatigue; D052580:Muscle Stretching Exercises; D016272:Occupational Health; D011446:Prospective Studies; D013514:Surgical Procedures, Operative; D013997:Time Factors