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At least 937 records · Page 52Linked to original sources
PubMed1995

Low flow anaesthesia reduces occupational exposure to inhalation anaesthetics. Environmental and biological measurements in operating room personnel.

In the present study we evaluated the occupational exposure to N2O and isoflurane during open circuit (OC) (fresh gas flow > or = minute volume) and low flow (LF) (fresh gas flow = 1.5 l/min) anaesthesia. The effects of active scavenging and of a charcoal filter positioned on the exhausting branch of the ventilator on environmental and urinary concentrations of inhalation anaesthetics were also investigated. The study was carried out in the same operating room provided with non-recirculating air changes (10 per hour). It involved anaesthetists and nurses during routine activity. N2O and isoflurane concentrations (time-weighted average) were measured after 3-hour continuous exposure: 1) in the environment at the level of the personnel's breathing zone (Ci); 2) in the environment at the ventilator zone (C); 3) in urine (Cu). During OC anaesthesia without active scavenging the breathing zone concentration of both N2O and isoflurane was very high (194.6 +/- 15.2 and 5.0 +/- 0.4 ppm, respectively). The activation of the scavenging greatly reduced the breathing zone concentration of N2O (31.6 +/- 4.1 ppm) and isoflurane (1.7 +/- 0.2 ppm). LF anaesthesia (with active scavenging) significantly reduced the environmental concentration of both anaesthetics (Ci N2O and isoflurane 22.7 +/- 1.8 and 0.6 +/- 0.04 ppm, respectively). During LF anaesthesia the breathing zone concentration of N2O remained low, even without scavenging (22.7 +/- 1.8 ppm). Similar results were obtained by measuring N2O and isoflurane concentrations at the ventilator zone and in urine.(ABSTRACT TRUNCATED AT 250 WORDS)

Air Pollutants, Occupational↗
PubMed1996

Efficacy of the Steri-Shield filtered exhaust helmet in limiting bacterial counts in the operating room during total joint arthroplasty.

Filtered exhaust helmets (space suits) have been reported as efficacious in decreasing wound infections following joint arthroplasty procedures; however, strict experimental control of the many variables related to the incidence of clinical infection has been lacking in these studies, making support of such conclusions difficult. Any potential benefit of filtered exhaust helmets in the control of infection rates can be logically assigned to the reduction of airborne bacterial counts within the operating room. A study was done using the Steri-Shield helmet (Bio-Medical Devices, Irvine, CA) to define its efficacy in limiting airborne bacterial contaminates during total joint arthroplasty. Forty-eight paired prosthetic hip and knee cases were evaluated using a block experimentation design. One case of each pair was done with all surgical and scrub personnel cloaked in Steri-Shield filtered exhaust helmets and the other with the same personnel in conventional paper hoods and masks. Air samples were obtained with an Anderson two-stage viable particle sampler (Anderson Samplers, Atlanta, GA) placed immediately adjacent to the wound. Quantitative microbial cultures were obtained. The filtered exhaust helmet evaluated in this study provided no increased protection against bacterial contamination in the area of the surgical field than conventional paper hoods and masks.

Air Microbiology↗
PubMed1983

Vulnerability of patients with obstructive hypertrophic cardiomyopathy to ventricular arrhythmia induction in the operating room. Analysis of 17 patients.

To evaluate vulnerability to ventricular arrhythmia induction, programmed electrical stimulation was performed in the operating room in 17 consecutive patients undergoing myotomy-myectomy for obstructive hypertrophic cardiomyopathy (HC). A control group of 5 patients undergoing coronary artery bypass grafting with normal left ventricular function and no previous myocardial infarction also was tested. Of the 17 patients with HC, 14 had inducible sustained ventricular tachycardia (VT) or ventricular fibrillation (VF), 1 had inducible unsustained VT and the remaining 2 had less than 6 ventricular beats. In contrast, none of the 5 control patients had an inducible sustained ventricular arrhythmia, 1 had inducible unsustained VT, and the remaining 4 had less than 3 ventricular beats. The difference between the 2 groups with respect to induction of a sustained ventricular arrhythmia, unsustained VT or less than 6 ventricular beats was significant (p less than 0.001). It is concluded that patients with severe obstructive HC are unusually vulnerable to ventricular arrhythmia induction. This suggests that spontaneous ventricular tachyarrhythmias may be an important cause of sudden death in patients with HC.

Adolescent↗
PubMed2005

Operating room efficiency and scheduling.

PURPOSE OF REVIEW: The review focuses on six papers published in 2004 that pertain to operating room (OR) efficiency. RECENT FINDINGS: When to release OR time was much less important than was having the correct OR allocations in the first place. If OR time must be released, then this decision should be based on the historical scheduled workload. Several interventions combined can reduce average turnover times by 7 min per case, probably reducing labor costs by approximately 1.5%. Use of a block room for patients undergoing brachial plexus anesthesia for upper extremity surgery reduces overall OR time by 4 min per upper extremity case. Improving prediction of case duration can reduce over-utilized OR time by just 5.4 min per OR per workday. SUMMARY: Interventions studied included changing when OR time was released, reducing surgical times, reducing turnover times, reducing OR times with block rooms, and improving prediction of case duration. The incremental improvements in OR efficiency and reductions in labor costs were small as compared with allocating OR time and scheduling cases appropriately.

Journal Article↗
PubMed1998

Enhancement of upper abdominal operative field access and exposure using an operating room table accessory to achieve 62 degree head up feet down tilt (extreme reverse trendelenburg position).

The usual available operating room table for general surgery procedures has a limitation of approximately 30 degrees ofhead up feet down tilt positioning. A recently developed accessory attachment for the Midmark 71OO General Surgery Table with the Extreme Reverse Trendelenburg Attachment (ERTA) has expanded the range ofhead up feet down tilt positioning to 62 degrees.

Journal Article↗