Night shifts impair surgical dexterity

November 22, 2001

Laparoscopic performance after one night on call in a surgical department: prospective study BMJ Volume 323, pp 1222-23

One night on call in a surgical department affects a surgeon's ability to perform laparoscopy (examination of the interior of the abdomen using a specialised viewing instrument), finds a study in this week's BMJ.

All 14 surgeons (11 men and three women) in training at teaching hospital in Denmark participated in the study. A night shift started at 3.30pm and finished at 9am the following day. All trainees had similar, limited experience in laparoscopic surgery.

Using a virtual reality surgical trainer, all participants performed nine repetitions of six tasks. The laparoscopic surgical skills of the 14 trainees were assessed on the 10th repetition of the task, which was performed during normal daytime working hours and again at 9.30am after a night on call with impaired sleep. The average total sleep time during the night on call was 1.5 hours.

Surgeons showed impaired speed and accuracy in simulated laparoscopic performance after a night on call, suggesting that significant deficits in psychomotor performance occur after 17 hours on call with disturbed night sleep, say the authors. Factors connected with surgical work, such as emergency workload, stress, and emotional demands, may potentiate the effects of sleep deprivation alone, they add.

"Further studies should determine how long it takes for surgeons' laparoscopic performance to recover after an extended period on duty and should be aimed at developing and evaluating countermeasures that can maximise alertness and reduce fatigue," they conclude.


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