Aim Routine alcohol testing of practicing physicians remains controversial since there are no uniform guidelines or legal regulations in the medical field. Our aim was to quantitatively study the acute and next-morning effects of breath alcohol concentration (BAC)-adjusted alcohol intake on overall simulated surgical performance and microtremor among senior vitreoretinal surgeons. Methods This prospective cohort study included 11 vitreoretinal surgeons (>10 years practice). Surgical performance was first assessed using the Eyesi surgical simulator following same-day alcohol consumption producing a BAC reading of 0.06%–0.10% (low-dose), followed by 0.11%–0.15% (high-dose). Dexterity was then evaluated after a ‘night out’ producing a high-dose BAC combined with a night’s sleep. Changes in the total score (0–700, worst-best) and tremor (0–100, best-worst) were measured. Results Surgeon performance declined after high-dose alcohol compared with low-dose alcohol (−8.60±10.77 vs −1.21±7.71, p=0.04, respectively). The performance during hangover was similar to low-dose alcohol (−1.76±14.47 vs −1.21±7.71, p=1.00, respectively). The performance during hangover tended to be better than after high-dose alcohol (−1.76±14.47 vs −8.60±10.77, p=0.09, respectively). Tremor increased during hangover compared with low-dose alcohol (7.33±21.65 vs −10.31±10.73, p=0.03, respectively). A trend toward greater tremor during hangover occurred compared with high-dose alcohol (7.33±21.65 vs −4.12±17.17, p=0.08, respectively). Conclusion Alcohol-related decline in simulated surgical dexterity among senior vitreoretinal surgeons was dose-dependent. Dexterity improved the following morning but remained comparable to after low-dose alcohol ingestion. Tremor increased during hangover compared with same-day intoxication. Further studies are needed to investigate extrapolations of these data to a real surgical environment regarding patient safety and surgeon performance. Data are available upon reasonable request. All data relevant to the study are included in the article or uploaded as supplementary information.

中文翻译：

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急性饮酒和宿醉后的玻璃体视网膜手术表现


由于医学领域没有统一的指南或法律规定，对执业医生进行常规酒精测试仍然存在争议。我们的目的是定量研究呼吸酒精浓度 (BAC) 调整的酒精摄入量对高级玻璃体视网膜外科医生的整体模拟手术表现和微震的急性影响和第二天早上的影响。方法 这项前瞻性队列研究包括 11 名玻璃体视网膜外科医生（执业时间超过 10 年）。首先使用 Eyesi 手术模拟器在当天饮酒后评估手术表现，产生的 BAC 读数为 0.06%–0.10%（低剂量），然后是 0.11%–0.15%（高剂量）。然后，在“晚上出去”产生高剂量 BAC 并结合一整夜的睡眠后，对敏捷性进行了评估。测量总分（0-700，最差-最佳）和震颤（0-100，最好-最差）的变化。结果 与低剂量酒精相比，高剂量酒精后外科医生的表现有所下降（分别为-8.60±10.77 vs -1.21±7.71，p=0.04）。宿醉期间的表现与低剂量酒精相似（分别为-1.76±14.47 vs -1.21±7.71，p=1.00）。宿醉期间的表现往往比高剂量饮酒后的表现更好（分别为-1.76±14.47 vs -8.60±10.77，p=0.09）。与低剂量酒精相比，宿醉期间震颤增加（分别为7.33±21.65 vs -10.31±10.73，p=0.03）。与高剂量酒精相比，宿醉期间震颤有更大的趋势（分别为7.33±21.65 vs -4.12±17.17，p=0.08）。结论 高级玻璃体视网膜外科医生模拟手术灵巧度与酒精相关的下降呈剂量依赖性。第二天早上，敏捷度有所提高，但仍与摄入低剂量酒精后相当。 与醉酒当天相比，宿醉期间震颤加剧。需要进一步的研究来研究将这些数据外推到真实手术环境中有关患者安全和外科医生表现的情况。数据可根据合理要求提供。与研究相关的所有数据都包含在文章中或作为补充信息上传。