title: [Intraoperative stress in orthopaedic spine surgery : Attending surgeon versus resident].
abstract: BACKGROUND
  Requirements for orthopaedic spine surgeons include occupational skills, concentration, physical fitness and psychological stress resistance, depending on the attending surgeon's or the resident's position.
  
  
  METHODS
  This study measured and evaluated stress-relevant cardiovascular parameters during 101 spinal surgical procedures of a 40-year old fellowship-trained spine surgeon with 12 years of practice. A training computer, personal scales and a thermometer were used to record the duration of surgery, heart rate, weight loss and calorie burning.
  
  
  RESULTS
  The average maximum heart rate as an attending surgeon (124 bpm) was significantly higher than the resident's heart rate (99 bmp). A higher stress level resulted in an increasingly higher average maximum heart rate according to the duration of surgery. The mean loss of body fluids at an average room temperature of 20.4 C after surgery was 0.82 kg (0 to 2.3 kg). The mean loss of body weight was calculated as 1.12% of the attending surgeon versus 0.59% of the resident.
  
  
  CONCLUSIONS
  Increasing complexity, longer duration and a higher potential of intraoperative complications arouse a strong response from the attending surgeon. The observed cardiovascular parameters are similar to those of a moderate to intense workout such as cycling. Long lasting surgeries result in a weight loss equivalent to a mild dehydration ranging from 2 to 5% of body fluids. Increasing dehydration will eventually worsen cognitive, visual and motor skills. Results of this study suggest early rehydration and utilization of mental relaxation techniques to minimize risks during prolonged, complex spine surgeries.
authors.affiliation: Univ.-Klinik für Orthopädie, Medizinische Universität Innsbruck, Christoph-Probst-Platz Innrain 52, 6020, Innsbruck, Österreich. jonas.kremer@student.i-med.ac.at.|, Freiherr-vom-Stein Str. 37, 65604, Elz, Deutschland. jonas.kremer@student.i-med.ac.at.
authors.forename: J
authors.initials: J
authors.lastname: Kremer
authors.affiliation: Univ.-Klinik für Orthopädie, Medizinische Universität Innsbruck, Christoph-Probst-Platz Innrain 52, 6020, Innsbruck, Österreich.
authors.forename: M
authors.initials: M
authors.lastname: Reinhold
mesh_terms: D000328:Adult; D004734:Energy Metabolism; D005858:Germany; D006339:Heart Rate; D006801:Humans; D007396:Internship and Residency; D007432:Intraoperative Period; D007796:Laminectomy / Q000523:psychology*; D008297:Male; D009784:Occupational Diseases / Q000503:physiopathology* / Q000523:psychology*; D019637:Orthopedic Procedures / Q000523:psychology; D000072161:Orthopedic Surgeons / Q000523:psychology*; D013315:Stress, Psychological / Q000503:physiopathology* / Q000523:psychology*; D014870:Water Loss, Insensible; D055815:Young Adult
keywords: Dehydration; Physiological stress; Psychological stress; Pulse rate; Surgery