Hung-over surgeons more error-prone

Surgeons might want to steer clear of alcohol the night before operating, according to a new report that shows a hangover fuels errors during simulated surgery.

While there is no question about the immediate effects of alcohol on surgical skills, there aren't any rules for how much doctors can drink the day before going to the operating room.

"Historically, the medical profession has had a reputation for high rates of alcohol consumption," Anthony Gallagher, of the Royal College of Surgeons in Ireland, and colleagues write in the Archives of Surgery.

Alcohol intake results

"It is likely that surgeons are unaware that next-day surgical performance may be compromised as a result of significant alcohol intake."

To measure the degree of that impairment, the researchers invited eight surgeons and 16 students out for a night on the town.

Half the students and all of the experts were encouraged to down as much booze as they wanted until they felt drunk. The rest of the students weren't allowed to touch any alcohol, but still went out for dinner.

The next day, the merrymakers, hung-over or not, went to the lab to perform a type of camera-guided surgery that uses a few small incisions instead of one big one - so-called laparoscopy.

The surgery

The surgery was done on a virtual reality system, not a real person. That turned out to be fortunate, because both the surgeons and those students who had been drunk did worse than when they were tested before the party.

At 9 AM, hung-over students made about 19 errors on average, while those who hadn't been drinking made only eight. This difference hadn't been seen before the night out, and faded over the day.

The surgeons also performed worse the day after their night out compared with before, with an increase in errors of about half. Yet only one of them had detectable blood alcohol levels.

For unclear reasons, the surgeons completed the surgery faster at 9 AM than they did before the party, but then became slower when tested at 1 PM.

Still, because they also made more errors and had trouble performing a type of heating used during surgery, this speediness didn't translate into a real improvement, the researchers note.

The take-home message?

"Abstinence from alcohol the night before operating may be a sensible consideration for practicing surgeons," the report urges.  (Reuters Health/ April 2011)

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