Does caffeine use hurt surgical performance by novice vitreoretinal surgeons?

Caffeine may negatively impact the performance of novice vitreoretinal surgeons, according to a study published in JAMA Ophthalmology. However, with the addition of propranolol, performances may be improved.

In this single-blind cross-sectional study, 15 vitreoretinal surgeons with <2 years of surgical experience performed 5 simulations daily for 2 days in a dry-laboratory setting. Performance was assessed through surgical simulation tasks 30 minutes after receiving placebo, low-dose caffeine (2.5 mg/kg), high-dose caffeine (5.0 mg/kg), and high-dose propranolol (0.6 mg/kg) on day 1 and placebo, low-dose propranolol (0.2 mg/kg), high-dose propranolol (0.6 mg/kg), and high-dose caffeine (5.0 mg/kg) on day 2.

Low-dose caffeine was associated with a worse total surgical score, a lower antitremor maneuver score, longer intraocular trajectory, and increased task completion time, compared with low-dose propranolol.

After ingesting caffeine and propranolol performance improved, however surgical performance remained inferior compared with low-dose propranolol alone for total surgical score, tremor-specific score, and intraocular trajectory.

“The findings suggest that performance of novice vitreoretinal surgeons was worse after receiving low-dose caffeine alone but improved after receiving low-dose propranolol alone. Their performance after receiving propranolol alone was better than after the combination of propranolol and caffeine. These results may be helpful for novice vitreoretinal surgeons to improve microsurgical performance,” the authors concluded.

Reference

Roizenblatt M, Dias Gomes Barrios Marin V, Grupenmacher AT, et al. Association of weight-ddjusted caffeine and β-Blocker use with ophthalmology fellow performance during simulated vitreoretinal microsurgery. JAMA Ophthalmol. Published online June 11, 2020. doi:10.1001/jamaophthalmol.2020.1971