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) 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.