Radiation Exposure of the Anesthesiologist in the Neurointerventional Suite

Abstract

Background: Scatter radiation during interventional radiology procedures can produce cataracts in participating medical personnel. Standard safety equipment for the radiologist includes eye protection. The typical configuration of fluoroscopy equipment directs radiation scatter away from the radiologist and toward the anesthesiologist. This study analyzed facial radiation exposure of the anesthesiologist during interventional neuroradiology procedures. Methods: Radiation exposure to the forehead of the anesthesiologist and radiologist was measured during 31 adult neuroradiologic procedures involving the head or neck. Variables hypothesized to affect anesthesiologist exposure were recorded for each procedure. These included total radiation emitted by fluoroscopic equipment, radiologist exposure, number of pharmacologic interventions performed by the anesthesiologist, and other variables. Results: Radiation exposure to the anesthesiologist's face averaged 6.5 Ϯ 5.4 Sv per interventional procedure. This exposure was more than 6-fold greater (P Ͻ 0.0005) than for noninterventional angiographic procedures (1.0 Ϯ 1.0) and averaged more than 3-fold the exposure of the radiologist (ratio, 3.2; 95% CI, 1.8 -4.5). Multiple linear regression analysis showed that the exposure of the anesthesiologist was correlated with the number of pharmacologic interventions performed by the anesthesiologist and the total exposure of the radiologist. Conclusions: Current guidelines for occupational radiation exposure to the eye are undergoing review and are likely to be

Radiation exposure to anaesthetists during endovascular procedures

“…A previous study reported that anaesthetists are exposed to 6.5 AE 5.4 lSv per procedure, more than three times greater than radiologists, during neuroradiological procedures [10]. Several studies have reported radiation exposure among vascular surgeons involved in fluoroscopy-assisted surgery [14][15][16], and found exposure to be within safe recommended limits.…”

“…The only previous study reported for interventional neuroradiology [10] included 31 patients, and contained no information about radiation exposure during EVAR. Unable to calculate an informed sample size, we selected a convenience sample in excess of 30 patients per group.…”

“…Although several previous studies have measured anaesthetists' radiation exposure [5][6][7][8][9][10], little is known about occupational exposure during endovascular procedures.…”

Radiation-Induced Cataractogenesis: A Critical Literature Review for the Interventional Radiologist

“…One study found low lens doses in neurointerventional procedures performed using a ceiling-suspended shield [40]. Efstathopoulos showed that, despite using a ceiling-suspended shield, a radiologist performing vertebroplasty with monoplane fluoroscopy was predicted to exceed the ICRP dose limit at 27.9 mSv/year [27].…”

Radiation Exposure during Neurointerventional Procedures in Modern Biplane Angiographic Systems: A Single-Site Experience

“…However, because of the complexity of the pathologies to be treated, there is a significant number of procedures requiring prolonged X-ray procedures or high-dose acquisitions, which can result in increased radiation exposure to the patients as well as staff members [5,6] , leading to potential deterministic and stochastic adverse effects [7] .…”