1 / 17

Allison Thiele, MD PhD University of Saskatchewan College of Medicine

Is sleep deprivation equal to being legally intoxicated in simulated laparoscopic performance in gynecologic surgeons?. Allison Thiele, MD PhD University of Saskatchewan College of Medicine Dept. of Obstetrics, Gynecology & Reproductive Sciences RQHR Research Day 2013. Background.

takoda
Download Presentation

Allison Thiele, MD PhD University of Saskatchewan College of Medicine

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Is sleep deprivation equal to being legally intoxicated in simulated laparoscopic performance in gynecologic surgeons? Allison Thiele, MD PhD University of Saskatchewan College of Medicine Dept. of Obstetrics, Gynecology & Reproductive Sciences RQHR Research Day 2013

  2. Background • Commercial truckers • Limits driving to 13h in a 24h period (Commercial Vehicle Drivers Hours of Service Regulations, Ministry of Justice, Nov 28, 2009) • Pilots • 14h work limit in 24h(Transport Canada) • Marine navigators • Mandatory 10h rest period in 24h(Transport Canada) • Surgeons • No regulation on work hours

  3. Background • Conflicting evidence regarding effects of sleep deprivation on physician performance • Negative impact on performance, cognition and mood (Dru et al, 2007; Koslowsky and Babkoff 1992; Pilcher and Huffcutt 1996) • Simulated laparoscopic skills in residents • ↑completion times and errors (Eastridge et al 2003, Taffinder et al 1998, Grantcharov et al 2001) • Improved economy of motion, ↓time and errors (DeMaria et al 2005) • Performance impairment is equal to BAC of 0.1%(Dawson and Reid 1997, Williamson and Feyer 2000)

  4. Study Rationale • Performance of surgical skills in a sleep deprived state have been compared to being legally drunk • However, there are no studies directly comparing sleep deprivation vs intoxication

  5. Study Rationale • Most research studies investigating surgical skills in sleep deprived state are with residents

  6. Objectives • To determine if sleep deprivation is equivalent to being legally drunk in performance of simulated laparoscopic surgical skills by staff surgeons

  7. Hypothesis • Being sleep deprived is not equivalent to being legally intoxicated in the performance of simulated laparoscopic surgical skills

  8. Methods • Participants: nine staff gynecologists with privileges to perform laparoscopic surgery in the RQHR and who provided informed consent • Performance of three tasks: • 2 conditions:

  9. Methods • Evaluated for task completion time, # of errors • Scored according to GOALS criteria • Analysis of data with repeated measures factorial ANOVA

  10. Time Sleep deprived EtOH Cup drop Pass the rope Peg transfer

  11. Error Sleep deprived EtOH Cup drop Pass the rope Peg transfer

  12. GOALS scoring Efficiency Depth perception Bimanual dexterity Cup drop Pass the rope Peg transfer Cup drop Pass the rope Peg transfer Cup drop Pass the rope Peg transfer Sleep deprived EtOH

  13. Overall performance Sleep deprived EtOH Cup drop Pass the rope Peg transfer

  14. Conclusions • More difficult tasks are harder to perform regardless of state • Although results were similar for the easier two tasks, there was a larger drop in performance for the hardest task when intoxicated • Suggests sleep deprivation is not equivalent to being legally intoxicated for the performance of surgical skills in staff surgeons

  15. Future Directions • Expand research participants to laparoscopic surgeons of several specialities • Investigate cognitive abilities in each state • Compare junior vs. senior residents vs. staff surgeons • Assess performance on LapMentor simulation trainer

  16. Acknowledgements • Co-authors: F. Mohtashami, E. Karreman, J. Thiel • Dilawri Simulation Centre • Murray Schiltz • Spencer Lawton • RQHR Ob/Gyns

  17. References • Eastridge, B.J., Hamilton, E.C., O’Keefe, G.E., Rege, R.V., Valentine, R.J., Jones, D.J., Tesfay, S. and Thal, E.R.. Effect of sleep deprivation on the performance of simulated laparoscopic surgical skill. The American Journal of Surgery (2003) 186, p169-174. • Grantcharov TP, Bardram L, Funch-Jensen P, et al. Laparoscopic performance after one night on call in a surgical department: prospective study. BMJ 2001;323:1222-1223. • Taffinder NJ, McManus IC, Gul Y, et al. Effect of sleep deprivation on surgeons’ dexterity on laparoscopy simulator. Lancet 1998;352:1191 • Dru M, Bruge P, Benoit O, Mason N, Combes X, Margenet A, Dhonneur G, Marty J. Overnight duty impairs behaviour, awake activity and sleep in medical doctors. European Journal of Emergency Medicine 2007; 14(4):199-203. • Pilcher JJ, Huffcutt AI. Effects of sleep deprivation on performance: a meta-analysis. Sleep. 1996 May;19(4):318–326. • Koslowsky M, Babkoff H. Meta-analysis of the relationship between total sleep deprivation and performance. ChronobiolInt 1992; 9: 132–136. • DeMaria EJ, McBride CL, Broderick, TJ, Kaplan BJ. Night call does not impair learning of laparoscopic skills. Surginnov 2005; 12(2):145-149. • Dawson D, Reid K. Fatigue, alcohol and performance impairment. Nature 1997;388:235. • Williamson AM, Feyer A-M. Moderate sleep deprivation produces impairments in cognitive and motor performance equivalent to legally prescribed levels of alcohol intoxication. Occup Environ Med 2000; 57:649-655.

More Related