OBJECTIVE To determine the influence of operating room familiarity on surgeon stress. BACKGROUND Regulating surgeon stress may improve patient safety. This study evaluated how assisting surgeon and operating room familiarity influence intraoperative heart rate variability among surgeons. METHODS Attending surgeons from seven specialties within four university hospitals in France were enrolled from 11/01/20-12/31/21. Vagal tone, an indicator of stress derived from heart rate variability, was assessed during the first five minutes after incision using the root mean square of successive differences (RMSSD). Higher RMSSD values indicate greater vagal tone. Team familiarity was quantified as the cumulative time the attending and assisting surgeons had operated together in the past, while operating rooms in which the surgeon conducted >10% of their operations were termed familiar. The effect of each on the RMSSD was assessed via a linear mixed-effect model adjusting for the random effect of the surgeon and possible confounders. RESULTS Overall, 643 surgeries performed by 37 surgeons were included. Median surgeon age was 49 years, 29(78.4%) were male, and 22(59.5%) were professors. Surgeons spent an average of 21.2 hours with the assisting surgeon prior to surgery and conducted 585(91.0%) of their operations in a familiar operating room. For every 10 additional hours spent operating together, ln(RMSSD) significantly increased by 0.018 (95%CI: 0.003 to 0.033, P=0.016). Familiar operating rooms also tended to increase surgeon ln(RMSSD) [0.098 (95%CI: -0.007 to 0.203, P=0.068)]. CONCLUSION Familiar assisting surgeons, and potentially operating rooms, increased surgeon vagal tone. Maintaining a stable operating room environment may improve surgeon stress and patient care.

中文翻译：

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熟悉的工作环境会影响外科医生在手术室的压力：一项多专业前瞻性队列研究。


目的 确定手术室熟悉程度对外科医生压力的影响。背景 调节外科医生的压力可以提高患者的安全性。本研究评估了协助外科医生和手术室的熟悉程度如何影响外科医生的术中心率变异性。方法 来自 11 年 01 月 20 日至 12 年 31 月 21 日招募了来自法国四所大学医院内七个专业的主治外科医生。迷走神经张力是源自心率变异性的压力指标，在切口后的前 5 分钟内使用连续差值的均方根 （RMSSD） 进行评估。较高的 RMSSD 值表示更大的迷走神经张力。团队熟悉度被量化为主治外科医生和协助外科医生过去一起手术的累积时间，而外科医生进行 >10% 手术的手术室被称为熟悉手术。通过线性混合效应模型评估每种对 RMSSD 的影响，该模型调整了外科医生的随机效应和可能的混杂因素。结果 共纳入 37 名外科医生进行的 643 例手术。外科医生的中位年龄为 49 岁，男性 29 例 （78.4%），教授 22 例 （59.5%）。外科医生在手术前平均花费 21.2 小时与协助外科医生在一起，并在熟悉的手术室进行了 585 例 （91.0%） 手术。共同运行每增加 10 小时，ln（RMSSD） 显著增加 0.018 （95% CI： 0.003 至 0.033，P = 0.016）。熟悉的手术室也倾向于增加外科医生 ln（RMSSD） [0.098 （95%CI： -0.007 至 0.203，P = 0.068）]。结论 熟悉的辅助外科医生，以及可能的手术室，增加了外科医生的迷走神经张力。保持稳定的手术室环境可以改善外科医生的压力和患者护理。