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性能


目的 由于医学领域没有统一的指导方针或法律法规，因此对执业医师进行常规酒精检测仍然存在争议。我们的目的是定量研究呼吸酒精浓度 （BAC） 调整后的酒精摄入量对高级玻璃体视网膜外科医生整体模拟手术性能和微震颤的急性和次日早晨影响。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 （>10 年实践）。首先使用 Eyesi 手术模拟器评估手术性能，在当天饮酒后产生 0.06%-0.10%（低剂量）的 BAC 读数，然后是 0.11%-0.15%（高剂量）。然后在产生高剂量 BAC 并结合一夜睡眠的“夜间外出”后评估灵巧度。测量总分 （0-700，最差-最好） 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 和 -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 和 -1.21±7.71，p=1.00）。宿醉后的表现往往优于高剂量酒精后 （分别为 -1.76±14.47 和 -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，宿醉时有更大的震颤趋势（分别为 7.33±21.65 和 -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活性的酒精相关下降是剂量依赖性的。第二天早上灵巧度有所改善，但仍与低剂量酒精摄入后相当。 与当天中毒相比，宿醉期间震颤增加。需要进一步的研究来调查这些数据对真实手术环境的推断，以了解患者安全和外科医生的表现。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。