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Even without a hangover, a surgeon's skills suffer after a night of heavy drinking, study finds

April 18, 2011|By Karen Kaplan, Los Angeles Times
  • There are no rules on the amount of alcohol a surgeon may (or may not) consume on the eve of a day in the operating room.
There are no rules on the amount of alcohol a surgeon may (or may not) consume… (Abdullah Muhsen / Reuters )

Would you want your surgeon to party hearty the night before you went under his scalpel?

Probably not. Yet there are no rules on the amount of alcohol a surgeon may (or may  not) consume on the eve of a day in the operating room. This despite the fact that 42% of healthcare workers acknowledged having a hangover at work, according to a 1993 study. And among doctors, surgeons are known to have a particular fondness for drinking, according to some other studies and the casual observations of many physicians.

So a group of researchers conducted an unusual experiment. They gathered up six surgeons with extensive experience in laparoscopic procedures — a "minimally invasive" type of surgery — and treated them to dinner in a restaurant. Along with that dinner, the surgeons were offered unlimited amounts of alcohol and instructed to drink until they felt they were intoxicated.

The researchers drove the doctors home that night and picked them up again the next morning, delivering them to a laboratory equipped with a simulator that uses virtual reality to let users practice their laparoscopic surgery techniques. The study focused on laparoscopic procedures because they place "intense demands" on "cognitive, perceptual, and visuospatial abilities," all of which can be derailed by drink.

The surgeons were tested on the simulator at 9 a.m., 1 p.m. and 4 p.m. Each time, their surgical skills were worse than they had been in a baseline test, though only the scores for the 1 p.m. effort lagged by a statistically significant margin. Among the problems: the surgeons made more errors and were less efficient at using diathermy to burn tissue as part of the surgical process. In the afternoon, the surgeons also took longer to complete their virtual procedures, though during the 9 a.m. test they actually went faster than they had at baseline.

All of the surgeons were tested on a breathalyzer before the virtual surgeries began, and at least five of the six passed. (One of the subjects in their group still had a blood-alcohol level above the legal limit for driving, but two of the members of their group were not surgeons so it's unclear if the person who was still drunk was a surgeon.) But the researchers didn't take comfort in the fact that there were few hangovers. Instead, they said they were bothered that surgeons had trouble in their virutal ORs even though they appeared sober.

The study was far too small to allow the researchers to say how long doctors should abstain from drinking before going into surgery. However, they advise that, "given the considerable cognitive, perceptual, visuospatial, and psychomotor challenges posed by modern image-guided surgical techniques, abstinence from alcohol the night before operating may be a sensible consideration for practicing surgeons."

The study was published Monday in Archives of Surgery.

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