Effect of electrosurgery in the operating room on surgeons’ blood indices: a simulation model and experiment on rabbits

OBJECTIVE: This study aimed to examine the content of surgical smoke in the operating room, and the health effects of exposure to surgical smoke on surgeons. METHODS: We measured the content of surgical smoke in the operating room. The effect of exposure to surgical smoke on surgeons was examined using rabbits. Surgical smoke distribution was simulated to study the route of spread of surgical smoke. The effect of an evacuator was also evaluated. RESULTS: In the operating room during electrosurgery, there was a high-content zone of surgical smoke (1.5 × 10(−2)%, carbon monoxide; 3.0 × 10(−2)%, carbon dioxide). In rabbit experiments, all groups that were exposed to surgical smoke showed significantly higher carboxyhemoglobin levels than did controls. Exposure to a high content of surgical smoke had a greater effect on blood indices than working continuously in the operating room. CONCLUSIONS: During electro-laparotomy, carbon monoxide in the high-content and low-content zones is higher than the United States Environmental Protection Agency’s limit. Carboxyhemoglobin levels may be > 10% with continuous operations over a week in the high-content zone in the operating room. Even with an evacuator, surgeons’ blood indices can still be affected by surgical smoke.