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SURGEON PERFORMANCE IMPAIRED AFTER DRINKING ALCOHOL THE DAY BEFORE SURGERY
Surgeons, like pilots, are held to a very high standard of conduct when it comes to alcohol and drug use. Unlike pilots, however, there are no rules barring surgeons from having a few beers, or other alcoholic drinks, on the day or evening before they enter the operating room to perform surgery.
While most surgeons drink alcohol responsibly, some surgeons (like people in any other profession) may occasionally have a few more drinks the day or evening before they report for duty than might be considered prudent. When a surgeon has a few more alcoholic drinks than they might have planned on the day before they are scheduled to perform surgery, most will undoubtedly assume that “sleeping it off” overnight will leave them fresh and in tip-top shape to wield the scalpel in the operating room on the next morning. However, a newly published clinical research study suggests otherwise….
A newly published prospective, randomized clinical study, which appears in the latest issue of the Archives of Surgery, included two groups of study volunteers. A total of 8 expert laparoscopic surgeons were included in one group, while the other group consisted of 16 university science students. All 24 participants were trained to use a computer-based laparoscopic surgery training device that is routinely utilized to train new surgeons in laparoscopic surgery skills. The science students were then divided into two groups. The “control” group abstained from alcohol for the 24-hour period prior to being tested on their laparoscopic skills, while the other half of the students (the “experimental group”) were allowed to drink alcohol freely until they felt themselves to be “intoxicated.” The 8 expert laparoscopic surgeons were all permitted to drink alcoholic beverages “until intoxicated.” The following day, all 24 study volunteers were tested on the laparoscopic training device at 9:00 AM, 1:00 PM, and 4:00 PM. All study participants also underwent breathalyzer testing to measure their blood alcohol level, and only one of the volunteers had a blood alcohol level above the legal limit (for driving) of 0.1 percent at 9:00 on the morning after their drinking binge.
Among the science students, performance deteriorated in all of the tested laparoscopic surgery skills among those who had consumed alcohol on the day prior to testing (when compared to the “control group” of students). The outcome was not any better for the expert laparoscopic surgeons, either. These experienced surgeons, all of whom consumed multiple alcoholic drinks on the day before testing, showed significant deterioration in the time that it took them to perform specific laparoscopic surgery skills, as well as a significant deterioration in their coordination and in the number of technical errors that they made. Moreover, this significant deterioration in surgical performance was still detectable at 4:00 PM on the day after these study volunteers had consumed multiple alcoholic beverages, and despite blood alcohol levels well below the legal limit for driving.
As previous research with airline pilots has shown, alcohol consumption within 24 hours of performing critical tasks can cause significant cognitive and physical impairment, even when blood alcohol levels are zero, or near zero. The findings of this clinical study of surgeons came to similar conclusions, and these findings suggest that surgeons should avoid the consumption of multiple alcoholic drinks within 24 hours of entering the operating room.
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Disclaimer: As always, my advice to readers is to seek the advice of your physician before making any significant changes in medications, diet, or level of physical activity
Dr. Wascher is an oncologic surgeon, professor of surgery, cancer researcher, oncology consultant, and a widely published author
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