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Persistent cognitive functioning deficits in operating rooms: two cases.

Elsa Dreyfus¹, Eve Tramoni, Marie-Pascale Lehucher-Michel

¹Consultation de Pathologie Professionnelle, AP-HM Timone, Marseille, France.

International Archives of Occupational and Environmental Health

|February 9, 2008

Summary

Operating room personnel can develop chronic toxic encephalopathy (CTE) from prolonged exposure to anesthetic gases. This study highlights the risks of nitrous oxide and the need for improved operating room safety measures.

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Area of Science:

Occupational Health
Neuroscience
Anesthesiology

Background:

Chronic toxic encephalopathy (CTE) has not been previously documented in operating room (OR) personnel.
OR environments can pose various occupational hazards to staff.

Observation:

Two anesthesiologists developed CTE after years of working in pediatric surgery.
Deficient air conditioning led to high concentrations of anesthetic gases (nitrous oxide and halogenated agents) in the ORs.

Findings:

Patients exhibited mood disturbances and non-specific neuropsychic deficits, leading to work cessation.
Neuropsychological assessments revealed significant deficits in attention, executive function, short-term memory, and visuospatial organization.
Standard medical and neuroimaging tests were normal, but symptoms improved after exposure cessation.

Implications:

Long-term exposure to high levels of anesthetic gases, especially nitrous oxide, can cause CTE in OR staff.
This case series underscores the critical need for implementing and enforcing preventive measures in operating rooms to mitigate occupational risks.