Case 7: Smell of Burning in the Operating Room

Abstract

A 65-year-old man (ASA 2) is undergoing a transurethral resection of the prostate under spinal anesthesia. Adequate regional anesthesia is established and no sedation is given at the patient’s request. Nasal oxygen 2 L/min is provided throughout the procedure. The patient’s legs, abdomen, and thorax are covered with sterile paper drapes. The surgeon encounters difficulty in passing the urethral scope. He disconnects the fiber-optic illumination system (FIS) and leaves it unprotected over the level of the pubic symphysis on the drapes. The surgeon cannot pass the scope and asks the scrub nurse for another. A few minutes later, the patient tells you, “I seem to smell burning.” You cannot smell anything, but after putting your nose near the patient’s head, you also smell smoke. What will you do? What can the problem be?