Intraoperative Pulse and Blood Pressure Recordings of Neurosurgeons

Abstract

Although hemodynamic changes in anesthetized patients remain well documented, no study has quantified the effect of operating stress on the neurosurgeon. We present a study of intraoperative (IOP) pulse and blood pressure (BP) recordings obtained from neurosurgeons and compare them with rest and exercise values. This prospective, single-blind comparative analysis used an ambulatory BP device to record IOP, rest and exercise BP, and pulse. The Student t test and chi test were used for statistical analysis. Five neurosurgeons performed 10 aneurysm clippings and 1 vestibular schwannoma excision. The average IOP pooled systolic, diastolic, and mean BPs and pulse rates were 140, 103, and 116 mm Hg and 94 bpm, respectively. Corresponding rest and exercise values were 116, 75, and 89 mm Hg and 76 bpm and 130, 99, and 109 mm Hg and 128 bpm, respectively. Average IOP mean and diastolic BPs were significantly elevated compared with rest readings (P = .032, P = .023). Episodes of severe IOP BP (systolic BP/diastolic BP > 180/110 mm Hg) accounted for 28% of all readings and were significantly increased over rest values (P < .001). The incidence of abnormal IOP BP (systolic BP/diastolic BP > 140/90 mm Hg) was also significantly greater than exercise and rest values (P < .001). Neurosurgery can induce a significant hemodynamic stress malresponse in the operating surgeon that appears to be greater than that induced by vigorous exercise. The correlation of this occupational hazard to long-term health and longevity remains to be studied.