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Tuesday, April 19, 2011

Persistent Next-Day Effects of Excessive Alcohol Consumption on Laparoscopic Surgical Performance



To examine the effect of previous-day excessive alcohol consumption on laparoscopic surgical performance.

Study 1 was a randomized controlled trial. Study 2 was a cohort study.

Sixteen science students (laparoscopic novices) participated in study 1. Eight laparoscopic experts participated in study 2.
  
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.

Assessment measures included time, economy of diathermy use, and error scores.

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).

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.




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