About Careers Internship MedBlog Contact us

Effect of Sleep Deficiency and Possible Surgical Complications Examined

by Thilaka Ravi on November 6, 2013 at 5:49 PM
Font : A-A+

Effect of Sleep Deficiency and Possible Surgical Complications Examined

Surgeons who had operated the night before an elective daytime gallbladder surgery did not have a higher rate of complications, reveals a study in the November 6 issue of JAMA.

"Lack of sleep is associated with impaired performance in many situations. To theoretically prevent medical errors, work-hour restrictions on surgeons in training were imposed. There are now proposals for similar work-hour restrictions on practicing surgeons. Several studies found no association between surgeon sleep deprivation as assessed by operating the night prior to an operation or when surgeons report few hours of sleep and patient outcomes. Prior studies were limited because of small sample sizes and being from single academic institutions. Consequently, there is insufficient evidence to conclude that surgeon performance is compromised by insufficient sleep the night prior to performing surgery," according to background information in the article.


Christopher Vinden, M.D., of Western University, London, Ontario, Canada, and colleagues examined if there was any association between operating the night before performing an elective cholecystectomy (gallbladder removal) and complications. The analysis was conducted using administrative health care databases in Ontario. Participants were 2,078 patients (across 102 community hospitals) who underwent elective laparoscopic cholecystectomies performed by surgeons (n = 331) who operated the overnight before (between midnight and 7 a.m.). Each of these patients was matched with 4 other elective laparoscopic cholecystectomy recipients (n = 8,312), performed by the same surgeon when there was no evidence that surgeon having operated the overnight before.

The primary outcome was conversion of a planned laparoscopic cholecystectomy (removing the gallbladder using a camera and tiny incisions) to an open cholecystectomy (large incision of the abdomen to remove the gallbladder) during the procedure. Although not always considered a complication, conversion to open cholecystectomy may serve as an aggregate end point for many complications, and patients view conversion as an unwanted outcome. Secondary outcomes included evidence of iatrogenic injures (injuries caused by the surgery) or death.

The researchers found no association between conversion rates to open operations and whether or not surgeons operated the night before (2.2 percent with vs. 1.9 percent without overnight operation); or to the risk of iatrogenic injuries (0.7 percent vs. 0.9 percent); or death (≤ 0.2 percent vs. 0.1 percent). These proportions were not statistically different.

The authors write that policies limiting attending surgeon work hours are controversial. "Critics suggest such policies reduce continuity in care, increase communication errors, and introduce the potential for a bystander effect (in which one surgeon may expect another to bear the burden for authority and responsibility). Restructuring health care delivery to prevent surgeons operating during the day after they operated the previous night would have important cost, staffing, and resource implications."

"These findings do not support safety concerns related to surgeons operating the night before performing elective surgery."

Source: Eurekalert


Recommended Readings

Latest Hospital News

 Prehabilitation: Preparing Patients for Surgery Boosts Outcomes
Is prehabilitation associated with improved outcomes in patients undergoing orthopedic surgery? Yes, it improved overall function in comparison with usual care.
 Surgical Road Map for Healthcare Welfare in Low- And Middle-Income Countries
An exploratory investigation in Ghana revealed that surgical site infection was a statistically significant variable in determining postoperative healthcare costs.
 Young Heart Patients Actively Take Part in Medical Care Decisions
Adolescents and young adults preferred more patient-led active decision-making while parents preferred more parent/physician-shared decision-making.
Hand Hygiene can Keep Healthcare-associated Infections at Bay
Is hand hygiene important in hospital settings? Clean hands can help patients and staff in healthcare settings to avoid healthcare-associated infections (HAIs). So, wash your hands
How Clean Hospitals can Reduce Antibiotic Resistance
Antibiotic resistance may result from poor hygiene practices in hospitals or other medical facilities, stated study.
View All
This site uses cookies to deliver our services.By using our site, you acknowledge that you have read and understand our Cookie Policy, Privacy Policy, and our Terms of Use  Ok, Got it. Close

Effect of Sleep Deficiency and Possible Surgical Complications Examined Personalised Printable Document (PDF)

Please complete this form and we'll send you a personalised information that is requested

You may use this for your own reference or forward it to your friends.

Please use the information prudently. If you are not a medical doctor please remember to consult your healthcare provider as this information is not a substitute for professional advice.

Name *

Email Address *

Country *

Areas of Interests