Department of Surgery, University of North Dakota, School of Medicine and Health Sciences, 501 North Columbia Road, Grand Forks, ND 58203, USA.
Am J Surg. 2013 Dec;206(6):964-8; discussion 967-8. doi: 10.1016/j.amjsurg.2013.08.006. Epub 2013 Sep 24.
Alcohol misuse is commonplace among health professionals. The effects of alcohol on cognition and dexterity have been shown up to 14 hours after alcohol intake. The aerospace industry has restrictions on alcohol intake, and there is pressure for the health care industry to do the same. Few studies have addressed the lingering impact alcohol has on surgical performance, and none have measured surgical dexterity using well-established Fundamentals of Laparoscopic Surgery benchmarks.
Twenty-seven surgeons participated in this study: 11 attending surgeons, 2 fellows, and 14 resident surgeons. Three Fundamentals of Laparoscopic Surgery tasks measured surgical dexterity: peg transfer, pattern cutting, and intracorporeal suturing. Performance on these tasks was measured before alcohol intake and the morning after a night of social drinking. Alcohol levels were measured via breathalyzer 20 minutes after completion of drinking and the following morning before testing. Time and accuracy were compared.
The mean blood alcohol level was .076 mg/100 mL blood. Times for peg transfer, pattern cutting, and intracorporeal suturing showed no differences. Accuracy in pattern cutting was not different, but accuracy for intracorporeal suturing was significantly worse the morning after alcohol intake.
The morning after moderate alcohol intake, the time to complete Fundamentals of Laparoscopic Surgery tasks was unchanged, but accuracy was worse.
酗酒在医疗专业人员中很常见。研究表明,饮酒后 14 小时内,酒精会对认知和灵巧度产生影响。航空航天业对饮酒有限制,医疗行业也有同样的压力。很少有研究探讨酒精对手术表现的持续影响,也没有使用腹腔镜手术基本技能的既定基准来衡量手术灵巧度。
本研究共有 27 名外科医生参与:11 名主治医生、2 名住院医师和 14 名住院医师。三项腹腔镜手术基本技能任务用于衡量手术灵巧度:套管针转移、图案切割和体腔内缝合。在饮酒前和社交饮酒后的第二天早上测量这些任务的表现。饮酒结束后 20 分钟和第二天早上通过呼气酒精测试器测量酒精水平。比较时间和准确性。
平均血液酒精浓度为 0.076 毫克/100 毫升血液。套管针转移、图案切割和体腔内缝合的时间没有差异。图案切割的准确性没有差异,但体腔内缝合的准确性在饮酒后的第二天早上明显更差。
适量饮酒后的第二天早上,完成腹腔镜手术基本技能任务的时间没有变化,但准确性更差。