Introduction: We hypothesized that sleep deprivation, caffeine intake and alcohol consuption the night prior to simulated neurosurgery may impact performance on a virtual reality neurosurgical stimulator

Methods: After IRB approval,trainees and faculty practiced a simulated bimanual hemostasis microsurgical task on the NeuroTouch Neurosurgical simulator (National Research Council, Canada) until it was mastered, when they felt well-rested. Participants attended a gathering where blood alcohol level (BAL) was measured 20 minutes following alcohol consumption. The module was repeated the following morning. Residents were also encouraged to repeat the task following sleep-deprivation and caffeine intake. A questionnaire documenting sleep, caffeine, and alcohol intake was completed with each use. Performance metrics included: time to complete task, volume of blood remaining, volume of brain removed, blood loss, successful hemostasis, and time in excessive force zone.

Results: There was no difference in any of the performance metrics between the sleep deprived versus non-sleep deprived groups. Average time to complete the task was 98 and 134 seconds in the caffeine (defined as 1 or more caffeinated beverages the day of simulator use) and non-caffeine groups respectively (P=0.02, unpaired t-test). Volume of blood remaining was 0.16 cc and 0.03 cc in the caffeine and non-caffeine groups respectively (not statistically significant). In the participants who consumed alcohol, the average BAL was 0.07 and 0.00 the night prior and morning of the task respectively. There was no statistical difference in any measures in the alcohol versus non-alcohol groups.

Conclusions: Caffeine may decrease the time to complete a surgical task but does not seem to improve performance. Sleep deprivation and moderate alcohol consumption the evening prior to a simulated microneurosurgical task do not appear to change performance. More participants and more complex modules on the simulator may differentiate groups. We acknowledge that simulator performance may not predict operative performance.

Patient Care: By using neurosurgical simulation, we hope to eventually be able to evaluate variables that may hinder surgical performance in the operating room

Learning Objectives: By the conclusion of the session, participants should be able to (1) describe the benefits and limitations of a virtual reality simulator in evaluating surgical dexterity; (2) discuss the impact of sleep deprivation on simulated surgical dexterity; (3) discuss the impact caffeine intake on simulated surgical dexterity; and (4) discuss the impact of alcohol consumption on simulated surgical dexterity

References: 1. Das P, Goyal T, Xue A, Kalatoor S, Guillaume D. Simulation Training in Neurological Surgery. Austin J Neurosurg. 2014;1(1): 6. 2. Gasco J, Holbrook TJ, Patel A, Smith A, Paulson D, Muns A, et al. Neurosurgery simulation in residency training, feasibility, cost, and educational benefit. Neurosurgery. 2013; 73 Suppl 1: 39-45.