ASSESSMENT OF SIMULATED SURGICAL DEXTERITY AFTER MODIFIABLE EXTERNAL EXPOSURES AMONG NOVICE VERSUS EXPERIENCED VITREORETINAL SURGEONS.

Autor:	Roizenblatt M; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.; Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil.; The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland., Gehlbach PL; The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, Maryland., Marin VDG; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil., Roizenblatt A; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil., Saraiva VDS; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.; Vision Institute, IPEPO, 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; Department of Ophthalmology, 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.; Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil., Magalhães O Jr; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil., Fernandes RAB; Keck School of Medicine, University of Southern California, Los Angeles, California; and., Stefanini FR; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil., Caiado R; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil., Jiramongkolchai K; Kaiser Permanente Medical Group, McLean, Virginia., Farah ME; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.; Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil., Belfort R Jr; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.; Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil., Maia M; Department of Ophthalmology, Universidade Federal de São Paulo, São Paulo, Brazil.; Vision Institute, IPEPO, Universidade Federal de São Paulo, São Paulo, Brazil.
Jazyk:	angličtina
Zdroj:	Retina (Philadelphia, Pa.) [Retina] 2024 May 01; Vol. 44 (5), pp. 820-830.
DOI:	10.1097/IAE.0000000000004045
Abstrakt:	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.
Databáze:	MEDLINE
Externí odkaz:	Zobrazit plný text záznamu