Gallagher Anthony G, Boyle Emily, Toner Paul, Neary Paul C, Andersen Dana K, Satava Richard M, Seymour Neal E
National Surgical Training Centre, Royal College of Surgeons in Ireland, RCSI House, 121 St Stephen's Green, Dublin 2, Ireland.
Arch Surg. 2011 Apr;146(4):419-26. doi: 10.1001/archsurg.2011.67.
To examine the effect of previous-day excessive alcohol consumption on laparoscopic surgical performance.
Study 1 was a randomized controlled trial. Study 2 was a cohort study.
Surgical skills laboratory.
Sixteen science students (laparoscopic novices) participated in study 1. Eight laparoscopic experts participated in study 2.
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.
Assessment measures included time, economy of diathermy use, and error scores.
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).
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.
探讨前一天过量饮酒对腹腔镜手术操作的影响。
研究1为随机对照试验。研究2为队列研究。
外科技能实验室。
16名理科学生(腹腔镜手术新手)参与研究1。8名腹腔镜专家参与研究2。
所有参与者均接受了虚拟现实微创外科训练器(MIST-VR)的培训。研究1中的参与者被随机分为戒酒组或饮酒至醉酒组。研究2中的所有受试者自由饮酒至醉酒。次日上午9点、下午1点和4点对受试者进行MIST-VR任务评估。
评估指标包括时间、电刀使用经济性和错误分数。
在研究1中,两组在基线时表现相似,但饮酒组在饮酒后所有操作指标上均出现恶化。总体而言,尽管两组之间的时间分数差异无统计学意义(P = 0.29),但两组在电刀(P < 0.03)和错误(P < 0.003)分数上存在显著差异。测试时间(P < 0.003)、电刀(P < 0.001)和错误(P < 0.001)也有显著影响。在研究2中,专家在饮酒后的时间(P < 0.02)、电刀(P < 0.001)和错误分数(P < 0.001)方面表现出类似的下降。
过量饮酒似乎在次日下午4点时仍会降低手术操作表现,这表明有必要制定关于承担临床手术责任前一晚饮酒的建议。