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Persistent next-day effects of excessive alcohol consumption on laparoscopic surgical performance
Anthony G Gallagher1, Emily Boyle, Paul Toner
1National Surgical Training Centre, Royal College of Surgeons in Ireland, RCSI House, 121 St Stephen's Green, Dublin 2, Ireland.
Objective:
To examine the effect of previous-day excessive alcohol consumption on laparoscopic surgical performance.
Design:
Study 1 was a randomized controlled trial. Study 2 was a cohort study.
Setting:
Surgical skills laboratory.
Participants:
Sixteen science students (laparoscopic novices) participated in study 1. Eight laparoscopic experts participated in study 2.
Interventions:
All participants were trained on the Minimally Invasive Surgical Trainer Virtual Reality (MIST-VR). The participants in study 1 were randomized to either abstain from alcohol or consume alcohol until intoxicated. All study 2 subjects freely consumed alcohol until intoxicated. Subjects were assessed the following day at 9 am, 1 pm, and 4 pm on MIST-VR tasks.
Main Outcome Measures:
Assessment measures included time, economy of diathermy use, and error scores.
Results:
In study 1, both groups performed similarly at baseline, but the alcohol group showed deterioration on all performance measures after alcohol consumption. Overall, although the time score differences between the 2 groups were not statistically significant (P = .29), there was a significant difference between the 2 groups' diathermy (P < .03) and error (P < .003) scores. There was also a significant effect for time of testing (P < .003), diathermy (P < .001), and errors (P < .001). In study 2, experts demonstrated a similar postalcohol performance decrement for time (P < .02), diathermy (P < .001), and error scores (P < .001).
Conclusion:
Excessive consumption of alcohol appeared to degrade surgical performance the following day even at 4 pm, suggesting the need to define recommendations regarding alcohol consumption the night before assuming clinical surgical responsibilities.
