nach oben

International Archives of Occupational and Environmental Health

Erschienen in:

01.10.2008 | Short Communication

Persistent cognitive functioning deficits in operating rooms: two cases

verfasst von: Elsa Dreyfus, Eve Tramoni, Marie-Pascale Lehucher-Michel

Erschienen in: International Archives of Occupational and Environmental Health | Ausgabe 1/2008

Einloggen, um Zugang zu erhalten

Abstract

Background

To date, chronic toxic encephalopathy (CTE) has never been described in operating room personnel.

Case report

We report two cases of anaesthetists who developed this pathology. They have both used anaesthetic gases for many years in paediatric surgery. Air conditioning was deficient during three years in operating rooms and atmospheric anaesthetics concentration was high (N₂O mean concentration: 311 ppm, peak levels 1,600 ppm; halogenated: 16 ppm, peak levels: 1,600 ppm).

Clinical symptoms

Mood troubles and non-specific neuropsychic deficits gradually evolved until they had to stop working. Neuropsychological assessment showed important deficits in attention, executive functioning, short-term memory and visuo-spatial organization. Blood tests, VEPs, MRI, neuroSPECT and cardiovascular exams were normal. Troubles had slowly improved after cessation of exposure and sequels still remain.

Conclusion

These CTE cases seem to be the consequence of a long-term exposure to important levels of anaesthetic gases, and particularly nitrous oxide. It points out the importance of preventive measures in operating rooms, where occupational hazards are varied.

Allison RH, Shirley AW, Smith G (1979) Treshold concentration of nitrous oxide affecting psychomotor performance. Br J Anaesth 51:177–180PubMedCrossRef

Bergamaschi E, Smargiassi A, Mutti A et al (1997) Peripheral markers of catecholaminergic dysfunction and symptoms of neurotoxicity among styrene-exposed workers. Int Arch Occup Environ Health 69:209–214PubMedCrossRef

Bergamaschi E, Mutti A, Cavazzini S (1996) Peripheral markers of neurochemicals effects among styrene-exposed workers. Neurotoxicology Fall-Winter 17(3–4):753–759

Brodsky JB, Cohen EN, Brown BW Jr et al (1981) Exposure to nitrous oxide and neurologic disease among dental professionals. Anesth Analg 60:297–301PubMedCrossRef

Bruce DL, Bach MJ (1976) Effects of trace anaesthetic gases on behavioral performance of volonteers. Br J Anaesth 48:871–876PubMedCrossRef

Fagan D, Paul DL, Tiplady B et al (1994) A dose-response study of the effects of inhaled nitrous oxide on psychological performance and mood. Psychopharmacology 116:333–338PubMedCrossRef

Gardner RJ (1989) Inhalation anaesthetics—exposure and control: a statistical comparison of personal exposures in operating theatres with and without anaesthetic gas scavenging. Ann Occup Hyg 33(2):159–173PubMedCrossRef

Juntunen J (1993) Neurotoxic syndromes and occupational exposure to solvents. Environ Res 60:98–111PubMedCrossRef

Korttila K, Pfaffi P, Linnoila M et al (1978) Operating room’s nurses psychomotor and driving skills after occupational exposure to halothane and nitrous oxide. Acta Anaesthesiol Scand 22(1):33–39PubMed

Layzer RB (1978) Myeloneuropathy after prolonged exposure to nitrous oxide. Lancet 9:2(8102):1227–1230

Lucchini R, Placidi D, Toffoletto F et al (1996) Neurotoxicity in operating room personnel working with gaseous and non gaseous anesthesia. Int Arch Occup Environ Health 68:188–192PubMedCrossRef

Meier A, Jost M, Ruegger M et al (1995) Narcotic gas burden of personnel in pediatric anesthesia. Anaesthesist 44:154–162PubMedCrossRef

Mutti A, Vescovi PP, Falzoi M et al (1984) Neuroendocrine effects of styrene on occupationally exposed workers. Scand J Work Environ Health 10(4):225–228PubMed

Rouch I, Wild P, Fontana JM et al (2003) Evaluation of the French version of EUROQUEST: a questionnaire for neurotoxic symptoms. Neurotoxicology 24:541–546PubMedCrossRef

Saurel-Cubizolles MJ, Estryn-Behar M, Mugnier N et al (1992) Neuropsychological symptoms and occupational exposure to anesthesics. Br J Ind Med 49:276–281PubMed

Scelsa NS (2000) Nitrous oxide. In: Spencer P, Schaumburg HH, Ludolph A (eds) Experimental and clinical neurotoxicology. Oxford University Press, New York, pp 882–889

Schuyt HC, Verberk MM (1996) Measurement and reduction of nitrous oxide in operating rooms. J Occup Environ Med 38(10):1036–1040PubMedCrossRef

Seppalainen AM, Antti-Poika M (1983) Time course of electrophysiological findings for patients with solvents poisonning. A descriptive study. Scand J Work Environ Health 9(1):15–24PubMed

Smith G, Shirley AW (1977) Failure to demonstrate effect of trace concentrations of nitrous oxide and halothane on psychomotor performance. Br J Anaesth 49(1):65–70PubMedCrossRef

Triebig G, Hallermann J (2001) Survey of solvent related chronic encephalopathy as an occupational disease in European countries. Occup Environ Med 58:575–581PubMedCrossRef

Van der Hoek JAF, Verberk MM, Hageman G (2000) Criteria for solvent-induced chronic toxic encephalopathy: a systematic review. Int Arch Environ Health 73:362–368CrossRef

White RF, Proctor SP (1997) Solvents and neurotoxicity. Lancet 349:1239–1243PubMedCrossRef

White RF, Feldman RG, Moss MB et al (1993) Magnetic resonance imaging (MRI), neurobehavioral testing, and toxic encephalopathy: two cases. Environ Res 61:117–123PubMedCrossRef

Titel: Persistent cognitive functioning deficits in operating rooms: two cases
verfasst von: Elsa Dreyfus
Eve Tramoni
Marie-Pascale Lehucher-Michel
Publikationsdatum: 01.10.2008
Verlag: Springer-Verlag
Erschienen in: International Archives of Occupational and Environmental Health / Ausgabe 1/2008
Print ISSN: 0340-0131
Elektronische ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-008-0302-8

Springer Medizin

Abstract

Background

Case report

Clinical symptoms

Conclusion

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 1/2008

Levels of 1-hydroxypyrene, symptoms and immunologic markers in vulcanization workers in the southern Sweden rubber industries

Parameters influencing health variables in a sample of 949 German teachers

Sick building syndrome in relation to air exchange rate, CO2, room temperature and relative air humidity in university computer classrooms: an experimental study

Visually-evoked P300 and NOGO potentials as indicators of central nervous system function in patients with vibration syndrome

Work stress and reduced health in young physicians: prospective evidence from Swiss residents

Study of the validity of a job-exposure matrix for psychosocial work factors: results from the national French SUMER survey