# Addressing mental and physical fatigue in major abdominal surgery by incorporating muscle stretches and hydration mini breaks

## TL;DR

This study shows that short hydration and stretch breaks during long abdominal surgeries can reduce fatigue and improve wellbeing for theatre staff.

## Contribution

The novel approach of incorporating hydration and muscle stretch breaks during major abdominal surgeries to mitigate fatigue is evaluated for the first time.

## Key findings

- Over half of participants reported surgical discomfort affecting stamina, posture, and concentration.
- Participants with breaks reported lower pain scores and improved mental and situational fatigue metrics.
- Regular breaks improved work-life balance and reduced stress for theatre personnel.

## Abstract

The purpose of this quality improvement project (QIP) was to identify factors contributing to mental and physical fatigue in major abdominal surgery and to attempt to mitigate the same by incorporating mini hydration breaks with targeted muscle stretches at regular intervals.

This prospective QIP was conducted in the Peritoneal Malignancy Unit of a national referral centre for peritoneal malignancy-related diseases between February and April 2022. Only procedures lasting longer than four hours were included and all theatre personnel were invited to participate. A baseline survey was conducted to ascertain the impact of mental and physical fatigue. Subsequently, a cross-over study design was utilised; for the first four weeks the procedure was performed with no breaks. This was followed with four weeks of intervention (hydration breaks and muscle stretches). Validated questionnaires (pain scores, occupational fatigue inventory and surgical task load measurement) were used to measure perceived physical and mental fatigue.

Over half (58%) of the 34 participants felt that surgical discomfort affected their stamina, posture and ability to concentrate. Work–life balance was affected in 44%, and 17% felt that it affected their sleep pattern with a minority considering shortening their careers. A reduction in the mean pain score at the end of the day in the group who had breaks (2.61 vs 2.16) was noted. There was global improvement in situational stress, distractibility, temporal and mental demands in the group who had regular breaks, amounting to improvements in self-perceived fatigue levels.

Theatre personnel involved in major surgery experience mental and physical stress that adversely affects work–life balance. Regular, short hydration breaks with muscle stretches can help improve mental and physical wellbeing of theatre personnel involved in major abdominal surgery.