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

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) anderror (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.