A Study on Effects of Leaking Carbon Dioxide Gas on Surgeons during Laparoscopic Surgeries

Mallikarjuna Manangi, Ranjitha Gangadharaiah, Santhosh S Chikkanayakanahalli, Madhuri Naik, Arun Balagatte Jayappa
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Abstract

Background: Laparoscopic surgery is gold standard for treating various abdominal diseases. Carbon dioxide, having high safety profile, is the most commonly used gas for insufflating peritoneal cavity for accurate visualization and operative manipulation. Despite the fact that CO 2 is naturally present in the atmosphere, i.e., 0.035 % (350 ppm), it is one of the most overlooked toxic gases. CO 2 breathing causes numerous cardiorespiratory responses and psychological reactions, such as impaired vision, diminished motor control, slowed responses, disorientation, or reduced attentional capacities that may jeopardize a worker’s health and safety. At high concentrations (8 % ), it has been shown to cause unconsciousness almost instantaneously and respiratory arrest within 1 minute. As laparoscopic surgeons are under constant exposure of leaking CO 2 gas, this study is taken up to evaluate the effects of CO 2 on them by a noninvasive technique that measures end-tidal CO 2 of operating surgeons at the beginning and end of laparoscopic surgeries. Objective: To evaluate the effects of leaking CO 2 gas on surgeons during laparoscopic surgeries. Methods: A Mini-Mental State Exam (MMSE) score and EtCO 2 levels (using a capnometer with 4 L of oxygen/minute) of operating surgeons were obtained before the start of surgery. After surgery, MMSE scores and EtCO 2 levels were again documented, compared, and analyzed using SPSS software. Results: The mean EtCO 2 before surgery was found to be 30.86 with standard deviation of 4.03 and that after surgery was 31.23 with standard deviation of 3.85 with mean duration of surgery being 73 minutes. Correlation of individual EtCO 2 values before and after surgery did not show significant changes ( p value = 0.534). The difference in MMSE scale scores before and after surgery for all participated surgeons was insignificant. Conclusion: In healthy surgeons performing laparoscopic surgeries, there are no effects following exposure to leaking carbon dioxide. Air quality, Laparoscopic surgeries, World Journal of Laparoscopic Surgery (2021): 10.5005/jp-journals-10033-1446
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腹腔镜手术中二氧化碳气体泄漏对外科医生影响的研究
背景:腹腔镜手术是治疗各种腹部疾病的黄金标准。二氧化碳具有很高的安全性,是腹膜腔内最常用的气体,用于精确的可视化和手术操作。尽管二氧化碳在大气中自然存在,即0.035%(350ppm),但它是最被忽视的有毒气体之一。二氧化碳呼吸会导致许多心肺反应和心理反应,如视力受损、运动控制减弱、反应迟钝、定向障碍或注意力下降,这些都可能危及工人的健康和安全。在高浓度(8%)下,它几乎会在瞬间引起昏迷,并在1分钟内引起呼吸停止。由于腹腔镜外科医生经常暴露在泄漏的二氧化碳气体中,本研究通过一种非侵入性技术来评估二氧化碳对他们的影响,该技术测量了腹腔镜手术开始和结束时手术外科医生的呼气末二氧化碳。目的:评价腹腔镜手术中CO2气体泄漏对外科医生的影响。方法:在手术开始前,获得手术外科医生的迷你精神状态检查(MMSE)评分和EtCO2水平(使用每分钟4升氧气的二氧化碳计)。术后,再次记录、比较MMSE评分和EtCO2水平,并使用SPSS软件进行分析。结果:术前EtCO2平均值为30.86,标准偏差为4.03;术后EtCO2平均为31.23,标准偏差3.85,平均手术时间为73分钟。个体EtCO2值在手术前后的相关性没有显示出显著变化(p值=0.534)。所有参与手术的外科医生在手术前后MMSE量表评分的差异不显著。结论:在进行腹腔镜手术的健康外科医生中,暴露于泄漏的二氧化碳不会产生任何影响。空气质量,腹腔镜手术,世界腹腔镜手术杂志(2021):10.5005/jp-journals-10033-1446
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