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Which Factors Affect the Stress of Intraoperative Orthopedic Surgeons by Using Electroencephalography Signals and Heart Rate Variability?

1
Department of Orthopedic Surgery, Yonsei University College of Medicine, Seoul 03722, Korea
2
Department of Orthopedic Surgery, Catholic-Kwandong University, Incheon 210-701, Korea
3
Department of Orthopedic Surgery, Ewha Womans University College of Medicine, Seoul 03760, Korea
4
Department of Orthopedic Surgery, National Health Insurance Service Ilsan Hospital, Goyang 10444, Korea
*
Author to whom correspondence should be addressed.
Academic Editors: Pierre J.M. Cluitmans and Mark van Gils
Sensors 2021, 21(12), 4016; https://doi.org/10.3390/s21124016
Received: 9 May 2021 / Revised: 4 June 2021 / Accepted: 8 June 2021 / Published: 10 June 2021
(This article belongs to the Special Issue Neurophysiological Monitoring)
Can we recognize intraoperative real-time stress of orthopedic surgeons and which factors affect the stress of intraoperative orthopedic surgeons with EEG and HRV? From June 2018 to November 2018, 265 consecutive records of intraoperative stress measures for orthopedic surgeons were compared. Intraoperative EEG waves and HRV, comprising beats per minute (BPM) and low frequency (LF)/high frequency (HF) ratio were gathered for stress-associated parameters. Differences in stress parameters according to the experience of surgeons, intraoperative blood loss, and operation time depending on whether or not a tourniquet were investigated. Stress-associated EEG signals including beta 3 waves were significantly higher compared to EEG at rest for novice surgeons as the procedure progressed. Among senior surgeons, the LF/HF ratio reflecting the physical demands of stress was higher than that of novice surgeons at all stages. In surgeries including tourniquets, operation time was positively correlated with stress parameters including beta 1, beta 2, beta 3 waves and BPM. In non-tourniquet orthopedic surgeries, intraoperative blood loss was positively correlated with beta 1, beta 2, and beta 3 waves. Among orthopedic surgeons, those with less experience demonstrated relatively higher levels of stress during surgery. Prolonged operation time or excessive intraoperative blood loss appear to be contributing factors that increase stress. View Full-Text
Keywords: intraoperative stress; orthopedic surgery; surgeon; electroencephalography; heart rate variability; wearable device intraoperative stress; orthopedic surgery; surgeon; electroencephalography; heart rate variability; wearable device
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MDPI and ACS Style

Kwon, J.-W.; Lee, S.-B.; Sung, S.; Park, Y.; Ha, J.-W.; Kim, G.; Suk, K.-S.; Kim, H.-S.; Lee, H.-M.; Moon, S.-H.; Lee, B.H. Which Factors Affect the Stress of Intraoperative Orthopedic Surgeons by Using Electroencephalography Signals and Heart Rate Variability? Sensors 2021, 21, 4016. https://doi.org/10.3390/s21124016

AMA Style

Kwon J-W, Lee S-B, Sung S, Park Y, Ha J-W, Kim G, Suk K-S, Kim H-S, Lee H-M, Moon S-H, Lee BH. Which Factors Affect the Stress of Intraoperative Orthopedic Surgeons by Using Electroencephalography Signals and Heart Rate Variability? Sensors. 2021; 21(12):4016. https://doi.org/10.3390/s21124016

Chicago/Turabian Style

Kwon, Ji-Won; Lee, Soo-Bin; Sung, Sahyun; Park, Yung; Ha, Joong-Won; Kim, Gihun; Suk, Kyung-Soo; Kim, Hak-Sun; Lee, Hwan-Mo; Moon, Seong-Hwan; Lee, Byung H. 2021. "Which Factors Affect the Stress of Intraoperative Orthopedic Surgeons by Using Electroencephalography Signals and Heart Rate Variability?" Sensors 21, no. 12: 4016. https://doi.org/10.3390/s21124016

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