Intraoperative changes of neurosurgeons’ pulse and blood pressure during cerebral aneurysms operations

Authors: Diana BILSKIENE, Kristina PUNDINAITE, Andrius MACAS, Arimantas TAMASAUSKAS

Summary: Introduction. Cardiovascular diseases are among the commonest causes of death among physicians. Persistent stress increases risk for hypertension, coronary heart disease and atherosclerosis. Surgery can be an important stressor, however, there is a paucity of studies investigating cardiovascular system response among surgeons performing surgeries. In the present study we evaluated changes of heart rate (HR) and blood pressure (BP) of neurosurgeons performing microsurgical clipping of intracranial artery aneurysms. Methods. The study was performed at the Department of Neurosurgery of the Lithuanian University of Health Sciences in a period from 2012 until 2014. Four neurosurgeons (all male, mean age 51 ± 10 years) were involved into the study. HR and BP were measured in six occasions: before skin incision; after opening of dura matter; after approach to an aneurysm; after microsurgical clipping of an aneurysm; after suturing of dura matter; and after skin closure. Results. Cardiovascular system response was recorder during 29 microsurgical clipping procedures. There was a gradual increase of HR from the start of the procedure until microsurgical clipping of an aneurysm. The greatest mean HR was after microsurgical clipping (87 beats/min) relative to other stages of the procedure (p<0.05). The greatest mean values of systolic (136 mmHg), diastolic (85 mmHg) and mean (102mmHg) BP were recorded after approach of an aneurysm and prior to microsurgical clipping. This increase of BP values was significantly greater (p<0.05) relative to the final stages of the procedure, i.e. dural and skin closure. Conclusions. Our results indicate that stress experienced during microsurgical clipping procedure is associated with significant cardiovascular system response among experienced neurosurgeons. Persistent stress can be associated with poor health outcomes, thus it
should be timely recognized and managed.

Keywords: Heart rate, blood pressure, surgery, aneurysm, stress.

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