Your browser doesn't support javascript.
loading
ASSESSMENT OF SIMULATED SURGICAL DEXTERITY AFTER MODIFIABLE EXTERNAL EXPOSURES AMONG NOVICE VERSUS EXPERIENCED VITREORETINAL SURGEONS.
Roizenblatt, Marina; Gehlbach, Peter L; Marin, Vitor D G; Roizenblatt, Arnaldo; Saraiva, Vinicius da S; Nakanami, Mauricio H; Noia, Luciana da C; Watanabe, Sung E S; Yasaki, Erika S; Passos, Renato M; Magalhães, Octaviano; Fernandes, Rodrigo A B; Stefanini, Francisco R; Caiado, Rafael; Jiramongkolchai, Kim; Farah, Michel E; Belfort, Rubens; Maia, Mauricio.
Afiliación
  • Roizenblatt M; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Gehlbach PL; Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Marin VDG; The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Roizenblatt A; The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland.
  • Saraiva VDS; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Nakanami MH; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Noia LDC; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Watanabe SES; Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Yasaki ES; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Passos RM; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Magalhães O; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Fernandes RAB; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Stefanini FR; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Caiado R; Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Jiramongkolchai K; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Farah ME; Keck School of Medicine, University of Southern California, Los Angeles, California; and.
  • Belfort R; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
  • Maia M; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.
Retina ; 44(5): 820-830, 2024 05 01.
Article en En | MEDLINE | ID: mdl-38194677
ABSTRACT

PURPOSE:

To evaluate novice and senior vitreoretinal surgeons after various exposures. Multiple comparisons ranked the importance of these exposures for surgical dexterity based on experience.

METHODS:

This prospective cohort study included 15 novice and 11 senior vitreoretinal surgeons (<2 and >10 years' practice, respectively). Eyesi-simulator tasks were performed after each exposure. Day 1, placebo, 2.5 mg/kg caffeine, and 5.0 mg/kg caffeine; day 2, placebo, 0.2 mg/kg propranolol, and 0.6 mg/kg propranolol; day 3, baseline simulation, breathalyzer readings of 0.06% to 0.10% and 0.11% to 0.15% blood alcohol concentrations; day 4, baseline simulation, push-up sets with 50% and 85% repetitions maximum; and day 5, 3-hour sleep deprivation. Eyesi-generated score (0-700, worst-best), out-of-tolerance tremor (0-100, best-worst), task completion time (minutes), and intraocular pathway (in millimeters) were measured.

RESULTS:

Novice surgeons performed worse after caffeine (-29.53, 95% confidence interval [CI] -57.80 to -1.27, P = 0.041) and alcohol (-51.33, 95% CI -80.49 to -22.16, P = 0.001) consumption. Alcohol caused longer intraocular instrument movement pathways (212.84 mm, 95% CI 34.03-391.65 mm, P = 0.02) and greater tremor (7.72, 95% CI 0.74-14.70, P = 0.003) among novices. Sleep deprivation negatively affected novice performance time (2.57 minutes, 95% CI 1.09-4.05 minutes, P = 0.001) and tremor (8.62, 95% CI 0.80-16.45, P = 0.03); however, their speed increased after propranolol (-1.43 minutes, 95% CI -2.71 to -0.15 minutes, P = 0.029). Senior surgeons' scores deteriorated only following alcohol consumption (-47.36, 95% CI -80.37 to -14.36, P = 0.005).

CONCLUSION:

Alcohol compromised all participants despite their expertise level. Experience negated the effects of caffeine, propranolol, exercise, and sleep deprivation on surgical skills.
Asunto(s)
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Competencia Clínica / Cirugía Vitreorretiniana / Oftalmólogos / Destreza Motora Tipo de estudio: Clinical_trials / Observational_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Retina Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Competencia Clínica / Cirugía Vitreorretiniana / Oftalmólogos / Destreza Motora Tipo de estudio: Clinical_trials / Observational_studies Límite: Adult / Female / Humans / Male / Middle aged Idioma: En Revista: Retina Año: 2024 Tipo del documento: Article País de afiliación: Brasil Pais de publicación: Estados Unidos