BACKGROUND: Sleep deprivation and disturbances in circadian rhythms generally lead to poor performance, but is there a link in surgery? This review aimed to determine whether fatigue has an impact on surgeon performance or surgical outcomes. METHODS: Studies were identified by searching EMBASE, CINAHL, PubMed, The Cochrane Library, Current Contents and clinical trials databases. Inclusion of relevant studies was by application of a predetermined protocol and independent assessment by two reviewers. Each included study was critically appraised for its study quality according to the methods used for Cochrane Reviews. Data from included studies were extracted by one researcher using standardized data extraction tables developed a priori and checked by a second researcher. RESULTS: From 823 potentially relevant studies, a total of 16 studies were included in this review: two randomized controlled trials, five non-randomized comparative studies and nine case series. Of five studies that directly measure clinical performance, three studies reported no significant difference as a result of sleep deprivation, while two studies found increases in complications or errors. Eleven studies assessed psychomotor skill performance using a variety of simulation-based methods when a participant was rested and/or fatigued. Two randomized controlled trials reported no significant differences, while the nine remaining studies reported mixed results. Surgical residents with less surgical training/experience appeared to be more affected than more senior residents. CONCLUSION: There is little evidence, as yet, to inform the issue of the effect of fatigue on surgical performance.
BACKGROUND:Sleep deprivation and disturbances in circadian rhythms generally lead to poor performance, but is there a link in surgery? This review aimed to determine whether fatigue has an impact on surgeon performance or surgical outcomes. METHODS: Studies were identified by searching EMBASE, CINAHL, PubMed, The Cochrane Library, Current Contents and clinical trials databases. Inclusion of relevant studies was by application of a predetermined protocol and independent assessment by two reviewers. Each included study was critically appraised for its study quality according to the methods used for Cochrane Reviews. Data from included studies were extracted by one researcher using standardized data extraction tables developed a priori and checked by a second researcher. RESULTS: From 823 potentially relevant studies, a total of 16 studies were included in this review: two randomized controlled trials, five non-randomized comparative studies and nine case series. Of five studies that directly measure clinical performance, three studies reported no significant difference as a result of sleep deprivation, while two studies found increases in complications or errors. Eleven studies assessed psychomotor skill performance using a variety of simulation-based methods when a participant was rested and/or fatigued. Two randomized controlled trials reported no significant differences, while the nine remaining studies reported mixed results. Surgical residents with less surgical training/experience appeared to be more affected than more senior residents. CONCLUSION: There is little evidence, as yet, to inform the issue of the effect of fatigue on surgical performance.
Authors: Jaisa Olasky; Amine Chellali; Ganesh Sankaranarayanan; Likun Zhang; Amie Miller; Suvranu De; Daniel B Jones; Steven D Schwaitzberg; Benjamin E Schneider; Caroline G L Cao Journal: Surg Endosc Date: 2014-03-27 Impact factor: 4.584
Authors: Ya Wei Tseng; S Swaroop Vedula; Anand Malpani; Narges Ahmidi; Kofi D O Boahene; Ira D Papel; Theda C Kontis; Jessica Maxwell; John R Wanamaker; Patrick J Byrne; Sonya Malekzadeh; Gregory D Hager; Lisa E Ishii; Masaru Ishii Journal: JAMA Facial Plast Surg Date: 2019-03-01 Impact factor: 4.611
Authors: Maximilian Peter Forssten; Ahmad Mohammad Ismail; Tomas Borg; Yang Cao; Per Wretenberg; Gary Alan Bass; Shahin Mohseni Journal: Eur J Trauma Emerg Surg Date: 2021-10-07 Impact factor: 3.693
Authors: Michelle Gates; Aireen Wingert; Robin Featherstone; Charles Samuels; Christopher Simon; Michele P Dyson Journal: BMJ Open Date: 2018-09-21 Impact factor: 2.692