Doctors who had a lot to drink the previous day appear to have impaired skills when performing surgery, researchers at the Royal College of Surgeons, Dublin, Ireland, reported in the journal Archives of Surgery after carrying out simulation tests. The authors wrote that alterations in some surgical skills were observed in virtual reality simulator tests carried out one day after excessive alcohol consumption.

The authors wrote:

"While surgical performance is certain to be impaired acutely with excessive alcohol consumption, there is little information that defines the persistence of this effect. The potential for both early and late alcohol-related performance problems to emerge during laparoscopic surgery is of particular concern given the intense demands it makes on cognitive, perceptual and visuospatial abilities and the known vulnerability of these human factors to the effects of alcohol."

Anthony G. Gallagher, Ph.D., and team set out to determine what the effects of previous-day excessive alcohol consumption might be on laparoscopic surgical performance - they used a naturalistic, true-life setting.

They carried out two studies. One included 16 final-year science students, all male. The other involved 8 laparoscopic experts. All 24 of them were trained on the MIST-Vr (Minimally Invasive Surgical Trainer Virtual Reality). On the first day, baseline assessments were recorded.

The students were randomly selected into two groups of eight, the alcohol consumption group and the control group. The control group participants consumed no alcohol; they participated in a group dinner. Those in the alcohol group were served alcoholic drinks and could consume as much as they wished. In a separate dinner, all the 8 experts were told to consume as much alcohol as they wanted. A researcher was present in each event, and observed and noted down signs of intoxication in both alcohol groups (8 students and 8 experts).

On the next day, all participants did simulated surgical skill performance tests on the MIST-VR at 9am 1pm and 4pm.

The researchers report the following results: The First Study

The Control Group - compared to the baseline test, there were no changes in performance in any of the three simulations. The Alcohol Group - worse performance was observed in all three measures - time, errors and economy of diathermy (ability to perform technique designed to produce local application of heat) The Alcohol Group participants were only seen to perform more slowly during the first simulation (9am) The Second Study

The experts (they all drank the previous day) made more mistakes in all three simulations compared to their baseline performance. They performed their tasks more rapidly during the 9am simulation than in their baseline assessments By 4pm performance had returned to baseline levels The researchers concluded:

"In the two studies reported herein, we showed persistent detrimental performance effects the day after excessive alcohol had been consumed. Given the considerable cognitive, perceptual, visuospatial and psychomotor challenges posed by modern image-guided surgical techniques, abstinence from alcohol the night before operating may be a sensible consideration for practicing surgeons."

"Persistent Next-Day Effects of Excessive Alcohol Consumption on Laparoscopic Surgical Performance"
Anthony G. Gallagher, PhD; Emily Boyle, MRCS; Paul Toner, PhD; Paul C. Neary, MD; Dana K. Andersen, MD, PhD; Richard M. Satava, MD; Neal E. Seymour, MD
Arch Surg. 2011;146(4):419-426. doi:10.1001/archsurg.2011.67