Time dependency assessment of muscular fatigue index and hand tremor under operating conditions.

The aim of this paper is to determine if operating has an effect on a surgeon's muscular fatigue and hand tremor. Electromyography and tremor measurements were taken throughout a day of operating from the brachioradialis (BR) and mid deltoid (MD) muscles of six head and neck surgery consultants and two Ear, Nose, and Throat (ENT) registrars. The percent change in Mean Frequency (MF) of their EMG signal and tremor amplitudes was compared to twenty normal controls performing desk work. It was found that operating led to an increase in the fatigue level and hand tremor in all subjects, compared to very little increase from within the controls study. It was also determined that the BR is used more than the MD muscle and hence fatigues at a faster rate. Surgeons should be aware that their muscular fatigue levels and consequently their hand tremor will increase as an operation progresses, therefore, if possible, more complex parts of the operation should be performed as early as possible.