Abstract

Objective: To assess the effects of prior caffeine intake on tremor control and internal limiting membrane peeling proficiency of experienced retinal surgeons using a microsurgical simulator. Methods: Experienced vitreoretinal surgeons were included. On two separate days, each subject underwent a test on a level 4 anti-tremor test and internal limiting membrane peeling test on a microsurgical simulator (Eye-Si/ Series 199, VRMagic, Sofware 2.9, Mannheim, Germany) first with no caffeine intake and after 40 minutes of taking an oral dose of caffeine (200 mg and 400 mg). Each subject underwent blood pressure and heart rate measurements before and 40 min after caffeine intake. The same technician measured both surgical performances. Results: Mean age was 46.4 ± 10.1 years. All subjects were male. The mean anti-tremor results were: baseline scores 61.2 ± 19.15, 200 mg 61.6 ± 12.63 and 400 mg 75.4 ± 15.09. The mean internal limiting membrane peeling results were: baseline score 55.9 ± 5.46, 200 mg 54.8 ± 10.05 and 400 mg 62.6 ± 9.63. Blood pressure and heart rate remained stable. After consumption of higher doses of caffeine some adverse effects were reported such as headache and a transient episode of anxiety. Conclusion: Caffeine consumption prior to surgery is discouraged by microsurgeons due to potential adverse effects. Our results showed no significant change on the surgical ability after 200 and 400 mg of oral caffeine. There was a non-significant improvement on the overall score after 400 mg.

Highlights

  • Caffeine is one of the most widely consumed behaviorally active substances in the world

  • There are negative aspects of caffeine intake: a high dose can result in a state of excitement and anxiety including adverse reactions like tachycardia, headache, palpitations, insomnia, restlessness, nervousness, and tremor

  • We aimed to investigate the association between caffeine intake and microsurgical performance by having experienced retinal surgeons perform standardized tasks in a microsurgical simulator under different doses of caffeine (0 mg, 200 mg and 400 mg)

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Summary

Introduction

Caffeine is one of the most widely consumed behaviorally active substances in the world. It mainly acts upon the central nervous system, with widely known physiological and psychological effects (increased alertness, enhanced vigilance, reduced fatigue) [1,2,3,4,5,6]. There are negative aspects of caffeine intake: a high dose can result in a state of excitement and anxiety including adverse reactions like tachycardia, headache, palpitations, insomnia, restlessness, nervousness, and tremor. Caffeine has a half-life of approximately 4-6 h, with a plasma peak time concentration following it ingestion between 30-60 minutes (average 40) [7]

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