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Clin Orthop Relat Res. 2008 Feb;466(2):411-6. doi: 10.1007/s11999-007-0037-y. Epub 2008 Jan 10.

Orthopaedic surgeons' cardiovascular response during total hip arthroplasty.

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Department of Orthopedic Surgery, Zagreb University School of Medicine and Clinical Hospital Centre Zagreb, Salata 7, HR-10000 Zagreb, Croatia.


The literature contains limited and contradictory information regarding the amount of physical effort and/or emotional stress needed to perform surgery. We therefore investigated cardiovascular response to psychophysical stress in orthopaedic surgeons while they were performing surgery. We monitored 29 male orthopaedic surgeons from four university centers while they performed total hip arthroplasties. Changes in their cardiovascular parameters were recorded by ambulatory monitoring methods. Exercise stress testing of each participant was used as a control state. We compared the cardiovascular response during surgery to energy requirements of everyday activities. Preoperative and postoperative testing showed lower values of cardiovascular parameters than during physically less difficult parts of the operation; physically more difficult phases of the operation additionally increased the values of parameters. We concluded performing total hip arthroplasty increases surgeons' cardiovascular parameters because of psychologic stress and physical effort. Excitement of the cardiovascular system during total hip arthroplasty appears similar to the excitement during moderate-intensity daily activities, such as walking the dog, leisurely bicycling, or climbing stairs.

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