title: Ruptured blebs and racing hearts: autonomic cardiac changes in neurosurgeons during microsurgical clipping of aneurysms.
abstract: BACKGROUND
  In this study, we intend to evaluate the autonomic changes occurring in neurosurgeons and thus the stress during microsurgical clipping of aneurysms.
  
  
  OBJECTIVE
  The aim of the current study is to evaluate the heart rate variability (HRV) of the neurosurgeons during microsurgical clipping of aneurysm by using continuous real time monitoring of the ECG intraoperatively.
  
  
  METHODS
  Lead II ECG was recorded using Bioharness(®) (Zephyr Technologies, Annapolis, MD) in 4 healthy neurosurgeons who performed 29 microsurgical clipping of aneurysms. ECG from 21 surgeries was analysed (LabChart(®) software, ADInstruments, Dunedin, New Zealand) across five stages: Baseline (BL), sylvian fissure dissection (SFD), perianeurysmal dissection (PAD), clipping of the aneurysm (CLIP) and haemostasis (HEMO).
  
  
  RESULTS
  There was a reduction in TP and an increased LF/HF ratio in spite of suppression of both LF and HF powers. Contrary to the common understanding that the sympathetic limb of the autonomic system mostly mediates responses during stress and anxiety, we found that there was a significant contribution of the parasympathetic system too.
authors.affiliation: a Departments of Clinical Neurosciences , National Institute of Mental Health and Neurosciences (NIMHANS) , Bangalore , India ;
authors.forename: Chaitanya
authors.initials: C
authors.lastname: Ganne
authors.affiliation: b Departments of Neurophysiology , National Institute of Mental Health and Neurosciences (NIMHANS) , Bangalore , India ;
authors.forename: Sathyaprabha N
authors.initials: SN
authors.lastname: Talkad
authors.affiliation: c Departments of Neurosurgery , National Institute of Mental Health and Neurosciences (NIMHANS) , Bangalore , India.
authors.forename: Dwarakanath
authors.initials: D
authors.lastname: Srinivas
authors.affiliation: c Departments of Neurosurgery , National Institute of Mental Health and Neurosciences (NIMHANS) , Bangalore , India.
authors.forename: Sampath
authors.initials: S
authors.lastname: Somanna
mesh_terms: D017542:Aneurysm, Ruptured / Q000601:surgery*; D001341:Autonomic Nervous System / Q000601:surgery*; D006339:Heart Rate; D006801:Humans; D002532:Intracranial Aneurysm / Q000601:surgery*; D008866:Microsurgery / Q000379:methods; D000069471:Neurosurgeons; D019635:Neurosurgical Procedures / Q000379:methods; D013525:Surgical Instruments
keywords: Aneurysms; autonomic; heart rate variability; neurosurgeons; parasympathetic activity