Going Under the Knife? Ask Your Surgeon How Much He Drank Last Night

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Some airlines have strict rules about how much pilots can drink the night before they’re supposed to fly, and now some researchers think similar rules should apply to surgeons the night before they operate.

In a two-part study involving 16 medical students and eight experienced surgeons, an international group of scientists found that getting intoxicated can affect a surgeon’s skill the following day. (More on TIME.com: The Lost Art of Doctoring)

The first trial required half of the medical students to indulge in a night of good food and drink, in which the participants were free to drink until they felt drunk. The other half had a good meal, but it was alcohol-free. All the volunteers were trained beforehand on a virtual simulator for laparoscopic surgery that tested core manipulating skills for operating on tissue while observing a monitor.

The next day, the students were tested on the simulator at 9 a.m., 1 p.m. and 4 p.m. Compared with their original performance on the simulator, those who had gotten drunk the previous night all performed worse throughout the following day, making errors that lead investigator Anthony Gallagher says “shouldn’t have been occurring in a real patient.” (More on TIME.com: Making Sense of Medical Statistics: What Patients Should Do)

Gallagher, a professor medicine at University College Cork in Ireland, says the group decided to study laparoscopic surgeons because of the high level of dexterity, skill and concentration required to operate via a computer screen that displays an image of the actual tissue.

Previous work has documented that alcohol can affect cognitive performance the following day, but the team of scientists was curious about the impact that over-indulging could have on psychomotor skills. “We didn’t expect that psychomotor skills for a relatively straightforward task that the individuals were very good at would be significantly impaired on the following day even at 4 o’clock in the afternoon,” he says. “That’s one of the things that shocked us most.”

To confirm their findings, Gallagher next tested a group of experienced laparoscopic surgeons to see if even these veterans would be affected by drinking the previous evening. And sure enough, they were. “Basically we found the same effect,” he says. “These results suggest that if you have too much to drink, your performance is significantly degraded the following day.” (More on Time.com: Photos: Your Doctor Wants You to Smoke)

That was true even among the doctors who no longer registered any alcohol in a breathalyzer test before their simulations (only one surgeon showed any residual alcohol in his breath).

Would the errors made by the surgeons on the simulator have harmed real patients? Gallagher would say only that the physicians “would not have been happy with their performance had they been operating on a real patient.”(More on Time.com: 4 Reasons Binge Drinking Is a Public Health Problem)

He notes that the findings could be applicable not just to laparoscopic surgeons but also to those who use guided imagery to perform procedures such as threading cathethers through the heart or targeting radiation for cancer treatment. Already, he says, some eye and neurosurgeons avoid drinking coffee prior to operating, or make sure they are well hydrated before entering the OR in order to avoid any tremors that could affect their performance during the procedure.  “I think these results are clear enough that medicine has to have a discussion about this,” he says. And in the meantime, if you’re going under the knife, it might be worth asking your surgeon what he did the night before.