| Effects of Electrocautery during Laparoscopic Cholecystectomy in Patients and Operating Room Contamination: The changes of carbon monoxide and carboxyhemoglobin. |
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Guie Yong Lee, Jong In Han, Choon Hi Lee |
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Department of Anesthesiology, College of Medicine, Ewha Womans University, Seoul, Korea. |
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| Abstract |
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Carbon monoxide is generated by incomplete combustion and pyrolysis of tissue in hypoxic environment, can be absorbed systemically from peritoneal cavity and can be a environmental harzard to operating room personnel, The purpose of this study was to determine whether carbon monoxide produced during laparoscopic cholecystectomy could absorbed significantly and could be dangerous to operating room personnel. Twenty five ASA class I, II patients scheduled to undergo laparoscopic cholecystectomy and fifteen anesthesiologist and residents were included in the study. Intraperitoneal gas was analyzed for the carbon monoxide concentration before the use of electrocautery, 5 minutes after the start of coagulation, just before evacuation of smoke, and at the end of the surgery.
Carboxyhemoglobin was analyzed before the use of electrocautery, at the end of surgery, and in the recovery room in patients. Before the use of electrocautery and the end of surgery, carbon monoxide concentration in operating room air and the level of venous carboxyhemoglobin of operating room personnel were also analyzed. The Results are as follows. 1) Carbon monoxide was produced in the abdominal cavity during the laparoscopic cholecystectomy. 2) Carbon monoxide was not detected in the operating room atmosphere.
3) There was no significant changes of carboxyhemoglobin in patients and operating personnel. In conclusion, there is no evidence of significant carbon monoxide absorption by patients and operating room personnel during the laparoscopic cholecystectomy. |
| Key Words:
Carbon monoxide; Carboxyhemoglobin; Laparoscopic cholecystectomy |
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