The effect of operating time on surgeon's hand tremor

Paul S. Slack, Chris J. Coulson, X. Ma, P. Pracy, S. Parmar, K. Webster

Research output: Contribution to journalArticlepeer-review


The objective of this prospective study, performed at two tertiary referral centers in the West Midlands, was to determine if operating has an effect on a surgeon's baseline tremor. A total of 10 head and neck surgery consultants, 2 ENT registrars and 19 normal controls participated in the study. The interventions were preoperative and postoperative tremor measurements for surgeons and pre and post-days' desk work for controls, with the main outcomes measure being the percentage change in tremor. No difference in baseline tremor was determined between consultants and registrars. Operating led to an increase in hand tremor in all subjects. Tremor increases in all subjects were directly proportional to the length of the time spent in operating. Operating compared to a normal day's desk work increased tremor by a factor of 8.4. In conclusion, surgeons should be aware that their tremor will increase as an operation progresses. More complex parts should be performed as early in the day as possible, or, in the case of a very long operation, a change of surgeons may occasionally be necessary.

Original languageEnglish
Pages (from-to)137-141
Number of pages5
JournalEuropean Archives of Oto-Rhino-laryngology
Issue number1
Early online date29 May 2008
Publication statusPublished - Jan 2009


  • surgery
  • tremor


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