Effect of Sleep Deprivation on Simulated Microsurgical Vascular Anastomosis

Abstract

Background: The effects of sleep deprivation on surgical performance have been well documented. However, reports on the effects of sleep deprivation on microneurosurgery are limited. This study aimed to investigate the effects of sleep deprivation on microneurosurgery. Methods: Ten neurosurgeons participated in the anastomosis of a vessel model using a microscope in sleep-deprived and normal states. We evaluated the procedure time (PT), stitch time (ST), interval time (IT), number of unachieved movements (NUM), leak rate, and practical scale for anastomosis quality assessment. Each parameter was compared between normal and sleep-deprived states. Sub-analyses were performed on the two groups based on PT and NUM under the normal state (proficient and non-proficient groups). Results: Although no significant differences were noted in PT, ST, NUM, leak rate, or practical scale, IT was significantly prolonged under sleep deprivation compared to the normal state (mean, 258.8 ± 94.0 vs. 199.3 ± 74.9 s, p = 0.02). IT was significantly prolonged under sleep deprivation in the non-proficient group based on both PT and NUM (PT, 234.2 ± 71.6 vs. 321.2 ± 44.7 s, p = 0.04, NUM, 173.3 ± 73.6 vs. 218.7 ± 97.7; p = 0.02), whereas no significant difference was observed in the proficient group (PT, 147.0 ± 47.0 vs. 165.3 ± 61.1 s, p = 0.25, NUM, 173.3 ± 73.6 vs. 218.7 ± 97.7; p = 0.25). Conclusions: Although IT was significantly prolonged under sleep deprivation in the non-proficient group, there was no decline in performance skills in either the proficient or non-proficient group. The effect of sleep deprivation may require caution in the non-proficient group, but it is possible that certain microneurosurgical outcomes can be achieved under sleep deprivation.