Heart rate increased by MD 26.51 (95% CI 18.73 to 34.28, p < 0.00001) and SDNN decreased by MD -9.68 ms (95% CI -15.90 to -3.45, p = 0.002) during surgery compared to rest, indicating increased stress in surgeons.
Systematic Review (n=74)
Does heart rate variability (HRV) accurately assess stress levels in surgeons during surgery?
HRV shows potential as a physiological marker of surgical stress, but current evidence is limited by small sample sizes and high heterogeneity, highlighting the need for standardized future studies.
Background: Surgeons’ stress can significantly impact performance, leading to medical errors. Various factors contribute to stress, including a procedure’s complexity and surgeon experience. However, the field currently lacks a standardised approach to measuring stress in surgeons of different ages and experience levels. Materials and Methods: This systematic review evaluated heart rate variability (HRV) measures used in surgery to assess stress, considering surgeon age and experience. We searched PubMed, Scopus, and Web of Science following PRISMA guidelines, focusing on studies reporting HRV measurements in surgeons during surgery and comparing different surgeries, procedures, or surgeon experiences. Results: Out of 1821 reviewed studies, nine papers met the criteria, which involved 74 subjects. These studies reported various HRV measures, including heart rate, RMSSD, SDNN, pNN50, LF/HF ratio, LF, and HF. Although all time-domain features tended to show a negative response to stress, frequency-domain measures exhibited consistent patterns. However, these findings should be considered preliminary due to the small number of papers, high heterogeneity among studies, and the fact that no study has established a standard for comparing HRV across different surgeon ages or experience levels. Conclusions: Finally, these findings call for future studies with robust designs to explore the use of HRV parameters for measuring stress over time while considering surgeon age and experience.
Almuhini et al. (Fri,) conducted a systematic review in Surgeons undergoing various surgical procedures with varied age and experience levels (n=74). Heart rate variability monitoring during surgery vs. Baseline or rest conditions for the same surgeons was evaluated on Change in heart rate variability (HRV) and heart rate as measures of surgeon stress during surgery compared to rest/baseline. Heart rate increased by MD 26.51 (95% CI 18.73 to 34.28, p < 0.00001) and SDNN decreased by MD -9.68 ms (95% CI -15.90 to -3.45, p = 0.002) during surgery compared to rest, indicating increased stress in surgeons.