title: Persistent next-day effects of excessive alcohol consumption on laparoscopic surgical performance.
abstract: OBJECTIVE
  To examine the effect of previous-day excessive alcohol consumption on laparoscopic surgical performance.
  
  
  METHODS
  Study 1 was a randomized controlled trial. Study 2 was a cohort study.
  
  
  METHODS
  Surgical skills laboratory.
  
  
  METHODS
  Sixteen science students (laparoscopic novices) participated in study 1. Eight laparoscopic experts participated in study 2.
  
  
  METHODS
  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.
  
  
  METHODS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: National Surgical Training Centre, Royal College of Surgeons in Ireland, RCSI House, 121 St Stephen's Green, Dublin 2, Ireland.
authors.forename: Anthony G
authors.initials: AG
authors.lastname: Gallagher
authors.forename: Emily
authors.initials: E
authors.lastname: Boyle
authors.forename: Paul
authors.initials: P
authors.lastname: Toner
authors.forename: Paul C
authors.initials: PC
authors.lastname: Neary
authors.forename: Dana K
authors.initials: DK
authors.lastname: Andersen
authors.forename: Richard M
authors.initials: RM
authors.lastname: Satava
authors.forename: Neal E
authors.initials: NE
authors.lastname: Seymour
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects*; D000704:Analysis of Variance; D015331:Cohort Studies; D004564:Electrocoagulation / Q000706:statistics & numerical data; D004867:Equipment Design; D005260:Female; D006801:Humans; D007494:Ireland; D010535:Laparoscopy / Q000592:standards*; D008297:Male; D008875:Middle Aged; D009048:Motor Skills; D010820:Physicians / Q000523:psychology / Q000706:statistics & numerical data*; D011597:Psychomotor Performance / Q000187:drug effects*; D013337:Students, Medical / Q000523:psychology / Q000706:statistics & numerical data*; D013997:Time Factors; D014584:User-Computer Interface