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Published on: September 5, 2012
Small amount of alcohol did not deteriorate microsurgical dexterity: a prospective laboratory study
Ville Vasankari1, Christian Eisenring2,3, Tobias Rossmann2,4
1Department of Neurosurgery, Helsinki University Hospital and University of Helsinki, P.O. Box 266, 00029, Helsinki, Finland. ville.vasankari@hus.fi.
Background:
Alcohol consumption has been reported to deteriorate surgical performance both immediately after consumption as well as on the next day. We studied the early effects of alcohol consumption on microsurgical manual dexterity in a laboratory setting.
Method:
Six neurosurgeons or neurosurgical residents (all male) performed micro- and macro suturing tasks after consuming variable amounts of alcohol. Each participant drank 0-4 doses of alcohol (14 g ethanol). After a delay of 60-157 min, he performed a macrosurgical and microsurgical task (with a surgical microscope). The tasks consisted of cutting and re-attaching a circular latex flap (diameter: 50 mm macrosuturing, 4 mm microsuturing) with eight interrupted sutures (4-0 multifilament macrosutures, 9-0 monofilament microsutures). We measured the time required to complete the sutures, and the amplitude and the frequency of physiological tremor during the suturing. In addition, we used a four-point ordinal scale to rank the quality of the sutures for each task. Each participant repeated the tasks several times on separate days varying the pre-task alcohol consumption (including one sober task at the end of the data collection).
Results:
A total of 93 surgical tasks (47 macrosurgical, 46 microsurgical) were performed. The fastest microsurgical suturing (median 11 min 49 s, [interquartile range (IQR) 654 to 761 s]) was recorded after three doses of alcohol (median blood alcohol level 0.32‰). The slowest microsurgical suturing (median 15 min 19 s, [IQR 666 to 1121 s]) was observed after one dose (median blood alcohol level 0‰). The quality of sutures was the worst (mean 0.70 [standard deviation (SD) 0.48] quality points lost) after three doses of alcohol and the best (mean 0.33 [SD 0.52] quality points lost) after four doses (median blood alcohol level 0.44‰).
Conclusions:
Consuming small amount of alcohol did not deteriorate microsurgical performance in our study. An observed reduction in physiological tremor may partially explain this.
Insights
This study found that consuming small amounts of alcohol did not impair microsurgical skills in neurosurgeons. Reduced physiological tremor may explain the preserved manual dexterity, suggesting alcohol
Area of Science:
- Neurosurgery
- Human Performance
- Toxicology
Background:
- Alcohol consumption is known to negatively impact surgical performance.
- The immediate and short-term effects of alcohol on microsurgical skills require further investigation.
Purpose of the Study:
- To evaluate the early effects of alcohol consumption on microsurgical manual dexterity.
- To assess the impact of varying alcohol doses on suturing time, tremor, and suture quality in a laboratory setting.
Main Methods:
- Six male neurosurgeons performed macro- and microsurgical suturing tasks after consuming 0-4 doses of alcohol (14g ethanol).
- Tasks involved suturing a latex flap, with measurements of time, tremor (amplitude and frequency), and suture quality.
- Participants completed tasks multiple times with varying alcohol intake, including a sober control.
Main Results:
- Microsurgical suturing was fastest after three doses of alcohol (0.32‰ blood alcohol level).
- Suture quality was worst after three doses and best after four doses (0.44‰ blood alcohol level).
- Physiological tremor was measured during suturing tasks.
Conclusions:
- Consuming small amounts of alcohol did not deteriorate microsurgical performance in this study.
- A potential reduction in physiological tremor may contribute to the observed lack of performance decline.
- Further research is needed to fully understand the complex relationship between alcohol and surgical dexterity.
