Effects of a moderate dose of alcohol on simulated laparoscopic surgical performance.
BACKGROUND
In medicine, there is no professional regulation of the drinking of alcohol, nor a body of experimental evidence on which such regulation might be based. Here we report the acute and longer-term ("hangover") effects of a moderate dose of alcohol on performance, as assessed objectively on a laparoscopic surgical simulator.


METHODS
In a single-blind, experimental study, medical student subjects were assigned randomly to an alcohol (1.05 mg/kg) or a placebo condition (n = 14 in each). The effects of alcohol on performance on the MIST Virtual Reality surgical simulator were examined 60-90 min and 600-630 min (after a night's sleep) following its ingestion. Measures of the number of errors, time taken, hand movement economy, and excessive use of diathermy were recorded.


RESULTS
On each measure, performance was significantly impaired 60-90 min following alcohol ingestion, but there was no hangover effect 600-630 min later, following a night's sleep. This impairment could not be attributed to between-group differences in either predrink performance, expertise or estimated sleep duration during the night preceding the experimental session.


CONCLUSIONS
Simulated surgical performance is impaired severely when estimated blood alcohol concentration (BAC) is just above the UK legal limit for driving. These results contribute new, objective and quantitative evidence to the current debate about the use and misuse of alcohol within the medical profession.
The North of England Wolfson Centre for Minimally Invasive Surgery, Manchester Royal Infirmary, Oxford Road, Manchester M13 9WL, United Kingdom.
A H
AH
Dorafshar
D J
DJ
O'Boyle
R F
RF
McCloy
D000328:Adult; D000435:Alcoholic Intoxication / Q000097:blood; D003198:Computer Simulation; D000431:Ethanol / Q000097:blood / Q000378:metabolism* / Q000494:pharmacology*; D006801:Humans; D010535:Laparoscopy / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data*; D008297:Male; D019060:Minimally Invasive Surgical Procedures / Q000592:standards / Q000706:statistics & numerical data*; D011597:Psychomotor Performance / Q000187:drug effects*; D016037:Single-Blind Method; D012890:Sleep / Q000187:drug effects; D013337:Students, Medical; D014584:User-Computer Interface
D000431:Ethanol