Non‐invasive variables to assess acute stress in surgical personnel: A pilot study

Aims/Purpose: To evaluate the use of non‐invasive markers of acute stress in healthcare workers during surgery.

Methods: Fifteen ophthalmologists (9 men; 6 women) and one interventional radiologist were recruited. They were assessed on two different days: a) at rest, early morning, at home; b) in the hospital, at four different time points: on arrival, before hand‐washing, after completion of surgery and approximately 30 minutes later. The following measurements were taken: a) heart rate (HR) and heart rate variability (HRV, an indicator of parasympathetic activity) using a Polar HR9 monitor and the EliteHRV® app; and b) salivary cortisol using ECLIA (Cobas 411® autoanalyzer, Roche Mannheim). Data were analysed using Sigmaplot® (Pearson correlation coefficient; one‐way repeated measures ANOVA).

Results: The sample consisted of individuals with a mean age of 40.4 ± 10.9 years and a mean professional experience of 10.5 ± 11.6 years. No significant correlations were found between the different variables on any of the days. However, on the day of surgery, both heart rate (HR) and salivary cortisol were significantly lower in the final measurement (HR = 67.9 ± 9.9 beats per minute; cortisol: 0.22 ± 0.10 μg/dL) compared to the preoperative values (HR = 74.6 ± 12.8 beats per minute, p = 0.004; cortisol: 0.47 ± 0.19 μg/dL, p = 0.001). In addition, heart rate variability (HRV) tended to be lower in the pre‐ and post‐intervention measurements.

Conclusions: This pilot study suggests that non‐invasive measurement of variables such as HR, HRV and salivary cortisol concentration may be useful in assessing the level of acute stress experienced by healthcare professionals during surgical activity. However, further studies are needed to identify the most sensitive and specific variables for this purpose.