Cardiac autonomic and cortisol stress responses to real operations in surgeons: relationship with individual psychobiological characteristics and experience

BackgroundSurgeons are exposed to high levels of intraoperative stress, which could compromise their psychological well-being in the long term. This study aimed at exploring the effects of real operations on the activity of stress response systems (i.e., cardiac autonomic function and hypothalamic-pituitary-adrenal axis) during and in the aftermath of surgery, and the moderating role of individual psychobiological characteristics and different levels of experience (senior vs expert surgeons).MethodsHeart rate, heart rate variability, and salivary cortisol measures (as indexes of cardiac autonomic and hypothalamic-pituitary-adrenal axis activity, respectively) were assessed during real operations and in the perioperative period in a sample of surgeons (n = 16). Surgeons' psychometric characteristics were collected using questionnaires. Results. Real operations triggered both cardiac autonomic and cortisol stress responses which were independent from surgeons' level of experience. Intraoperative stress responses did not affect cardiac autonomic activity during the following night but were associated with a blunted cortisol awakening response. Moreover, senior surgeons reported higher levels of negative affectivity and depressive symptoms than expert surgeons prior to the surgery. Lastly, the magnitude of heart rate responses to surgery positively correlated with scores on negative affectivity, depression, perceived stress, and trait anxiety scales.ConclusionThis exploratory study allows to put forward the hypotheses that in surgeons cardiac autonomic and cortisol stress responses to real operations (i) may be associated with specific individual psychological characteristics regardless of the level of experience, (ii) and may have a longer lasting impact on hypothalamic-pituitary-adrenal axis function with potential implications for surgeons' physical and psychological well-being.

Automated summary

This study aimed to explore the effects of real operations on cardiac autonomic function and hypothalamic-pituitary-adrenal axis activity in surgeons, as well as the moderating role of individual psychobiological characteristics and experience levels. The results showed that real operations triggered stress responses in both cardiac autonomic function and cortisol levels, regardless of experience. These responses did not affect cardiac autonomic activity during the following night but were associated with a blunted cortisol awakening response. It was also found that senior surgeons had higher levels of negative affectivity and depressive symptoms compared to expert surgeons, and the magnitude of heart rate responses to surgery correlated with negative affectivity, depression, perceived stress, and trait anxiety scores.